急性缺血性脑卒中患者血清PAI-1、Aβ水平及其与病情严重程度的相关性分析

The levels of serum PAI-1,Aβin patients with acute ischemic stroke and correlation analysis with severity

目的:探讨急性缺血性脑卒中(AIS)患者血清1型纤溶酶原激活物抑制剂(PAI-1)、β淀粉样蛋白(Aβ)水平及其与病情严重程度的相关性。方法:收集2015-03-2016-11我院收治的69例AIS患者(观察组)病例资料,于入院24h内进行美国国立卫生院卒中量表(NIHSS)评分,并进行神经功能缺损程度评分。根据NIHSS评分及神经功能缺损程度评分,将69例观察组患者分为轻型(16例)、中型(44例)、重型(9例)3个亚组,同时收集23例健康体检者为对照组。用ELISA法检测2组血清PAI-1、Aβ水平。观察组血清PAI-1、Aβ水平与神经功能缺损程度评分的Pearson相关分析。结果:观察组血清PAI-1、Aβ水平[(49.34±10.72)mg/L、(176.38±92.46)pg/ml]与对照组[(36.87±8.56)mg/L、(142.25±81.43)pg/ml]比较,差异有统计学意义(P<0.05)。中型组血清PAI-1、Aβ水平[(51.25±9.68)mg/L、(178.47±96.32)pg/ml)]、重型组血清PAI-1、Aβ水平[(55.47±13.43)mg/L、(216.32±117.45)pg/ml]分别与轻型组[(42.54±7.62)mg/L、(152.35±82.56)g/ml]比较,差异均有统计学意义(P<0.05)。重型组血清Aβ水平与中型组比较差异有统计学意义[(216.32±117.45)pg/ml vs.(178.47±96.32)pg/ml,P<0.05]。重型组血清PAI-1水平高于中型组,但差异无统计学意义[(55.47±13.43)mg/L vs.(51.25±9.68)mg/L,P>0.05]。Pearson相关分析显示,血清PAI-1水平与AIS病情严重程度(神经功能缺损程度评分)之间呈正相关(r=0.941,P<0.01)。血清Aβ水平与AIS病情严重程度(神经功能缺损程度评分)之间呈正相关(r=0.882,P<0.01)。结论:AIS患者存在血清PAI-1、Aβ水平升高。Pearson相关分析显示:血清PAI-1、Aβ水平与AIS患者病情严重程度呈正相关,提示血清PAI-1、Aβ水平是AIS病情严重程度的重要指标,可为临床评价AIS病情严重程度提供重要的参考价值。

Objective：To explore serum levels of plasminogen activator inhibitor-1 （PAI-1）and amyloid 13 （Aβ） in patients with acute isehemic stroke （AIS） and analysis correlation with severity. Method： A total of 69 AIS pa- tients were enrolled in this study as observation group. The National Institutes of Health Stroke Scale （NIHSS） score and the neurological deficit score was performed with in 24 hours of admission. Sixty nine patients were di- vided into mild （n= 16）, moderate （n = 44） and severe （n =9） according to their NIHSS score and neurological deficit score. Twenty three healthy subjects were enrolled as the control group. Serum levels of PAl-1 and A13 were detected by EI,ISA. Pearson correlation analysis of serum levels of PAI-1, A13 and neurological deficit score was performed in the observation group. Result： Serum levels of PAI-1 and A13 in the observation group [（49. 34 _＋ 10.72） mg/L, （176.38--/-_92. 46） pg/ml] were higher than those in the control group [（36.87＋8. 56） mg/L, （142.25~81.43） pg/ml]（P^0.05）. The levels of serum PAI-1 and A13 in the moderate group [（51.25i9.68） mg/L,（178. 47_＋96. 32） pg/ml）] ,and in the severe group [（55.47＋_ 13.43） mg/L, （216.32_＋_ 117.45） pg/ml）] were higher than those in the mild group [（42.54_＋_7.62） mg/L,（152. 354-_82.56） g/ml]（P^0.05） ,respective- ly. The level of serum A13 in the severe group were significantly different from that in the moderate group [（216.32_＋117.45） pg/ml vs. （178.47--＋_96.32） pg/ml,P〈~0.05]. The level of serum PAI-1 in the severe group were higher than those in the moderate group,but the difference was not statistically significant [（55.47＋_ 13.43） mg/L vs. （51.25=k 9.68） rag/L, P^0. 05]. Pearson correlation analysis manifested the level of serumPAI-1 and A13 were positively correlated with the severity of AIS （the neurological deficit score） respectively （r=0. 941 ,P~ 0.01 ;r= 0. 882, P^0.01）. Conclusion：Serum levels of PAI-1 and A13 were elevated in AIS patients. Pearson corre-lation analysis demonstrated that the levels of serum PAI-1 and AI3 were both positively correlated with the severi- ty of AIS （the neurological deficit score）, which suggested that the levels of serum PAI-1 and AI3 may be important indicators of the severity of AIS and could provide crucial reference for clinical evaluation of the severity of AIS.