非对称性二甲基精氨酸在脑梗死患者急性期的表达

Expression of asymmetric dimethylarginine in patients with acute cerebral infarction

目的探讨血浆非对称性二甲基精氨酸（ADMA）在脑梗死患者急性期的表达及脑梗死危险因素分析。方法回顾性纳入2013年3月至2015年8月于西安医学院第一附属医院神经内科住院的100例脑梗死急性期患者为脑梗死组,依据美国国立卫生研究院卒中量表（NIHSS）评分,分为轻型梗死组（〈4分,21例）、中型梗死组（4~15分,49例）、重型梗死组（〉15分,30例）;同期体检无脑血管疾病者100例作为对照组。采用酶联免疫吸附法检测血浆ADMA浓度,比较各组间血浆ADMA水平。结果急性脑梗死轻、中、重型3个组及对照组血浆ADMA水平分别为（0.80±0.16）、（1.14±0.28）、（1.33±0.33）、（0.52±0.16）μmol/L,组间比较,差异有统计学意义（F=2.32,P〈0.05）。经多因素Logistic回归分析后,提示高ADMA水平是脑梗死急性期的独立危险因素（OR=1.140,95%CI：1.078~1.212,P=0.045）。结论血浆ADMA水平在轻、中、重型脑梗死患者中表达逐渐升高,ADMA水平越高,神经功能缺损越严重。ADMA可能是脑梗死急性期的独立危险因素。

Objective To investigate the serum asymmetric dimethylarginine （ADMA） expression in patients with acute cerebral infarction. Methods A total of 100 patients with acute cerebral infarction admitted to the Department of Neurology,the First Affiliated Hospital of Xi＇an Medical College from March 2013 to August 2015 were enrolled retrospectively. According to the National Institutes of Health Stroke Scale （NIHSS） scores,they were divided into three groups ：mild infarction （n = 21 ; 〈 4）, moderate infarction （n =49;4-15）,and severe cerebral infarction （n =30; 〉15）;100 healthy subjects without cerebrovascular disease in the same period were used as a control group. Enzyme linked immunoserbent assay was used to detect the plasma ADMA concentration,and the levels of plasma ADMA among the groups were compared. Results The concentrations of plasma ADMA of the mild,moderate,severe cerebral infarction,and the control groups were 0. 80 ±0. 16,1.14 ± 0.28,1.33 ± 0.33 ,and0. 52 ± 0.16 μmol/L, respectively. There were significant differences among the groups （F = 2. 32,P 〈 0. 05）. Multivariate logistic regression analysis suggested that ADMA was an independent risk factor for cerebral infarction （ OR,1. 140,95% CI 1. 078 - 1. 212,P=0. 045）. Conclusions The expression levels of plasma ADMA increased gradually in patients with mild,moderate,and severe cerebral infarction. The higher the ADMA levels ,the severe the neurological deficit would be. ADMA might be an independent risk factor for cerebral infarction.