缺血修饰蛋白与急性脑梗死体积相关性分析

Correlation Analysis of Ischemia Modified Protein and Volume of Acute Cerebral Infarction

目的探讨缺血修饰蛋白与急性脑梗死患者梗死体积及神经功能缺损程度的相关性。方法纳入我院2014年1月至2016年1月收治的急性脑梗死患者73例,根据脑梗死体积将患者分为3组(小梗死灶组<5cm^3,5cm^3≤中梗死灶组≤15cm^3,大梗死灶组>15cm^3),同时纳入同期来我院体检的健康体检者20例作为对照。所有患者均行影像学检查,按照多田公式(V=π/6×长×宽×层面数)计算梗塞病灶的体积。采用双抗体夹心法测定标本中人缺血修饰白蛋白(IMA)水平进行IMA测定,根据美国国立卫生研究院卒中量表(NIH Stroke Scale,NIHSS)作为临床神经功能缺损程度评分标准对急性脑梗死患者进行评分。比较各组患者IMA水平,分析IMA水平与梗塞病灶体积及NIHSS评分的相关性。结果急性脑梗死患者IMA水平与对照组比较差异有统计学意义(P<0.01);小梗死灶组、中梗死灶组、大梗死灶组与对照组比较差异有统计学意义(P<0.01);小梗死灶组IMA水平与中梗死灶组、大梗死灶组比较差异有统计学意义(P<0.01);大梗死灶组IMA水平与中梗死灶组比较差异有统计学意义(P<0.01)。急性脑梗死患者IMA水平与脑梗死体积呈正相关(r=0.61,P=0.02),与NIHSS评分呈正相关(r=0.69,P=0.00)。小梗死灶组、中梗死灶组IMA与脑梗死体积、NIHSS评分呈正相关,大梗死灶组ACB与NIHSS评分呈正相关。结论 IMA水平与急性脑梗死患者的脑梗死体积具有正相关性,对患者病情的判断和临床早期诊治具有极为重要的意义。

Objective To investigate the correlation between ischemia modified protein and infarct volume and defect de- gree of neurological function in patients with acute cerebral infarction. Methods 73 patients with acute cerebral infarction admit- ted to our hospital from January 2014 to January 2016 were selected and divided into 3 groups（ small infarction group 〈 5cm3, 5cm3 ≤middle infarction group ≤ 15cm3, large infarction group 〉 15cm3） according to the volume of cerebral infarction. At the same time,20 healthy adults admitted to our hospital for medical examinationduring the same period were ramtomly selected as the control group. All patients received imaging examination, and the infarct volume was calculated according to the Duotian formula （ V = π/6 × length × width × level number）. The level of human ischemia modified albumin（IMA） in the specimenwas measured by double antibody sandwich method. And the National Institutes of Health Stroke Scale（ NIH Stroke Scale, NIHSS）was used as a scoring criterion to score the degree of clinical neurological impairment in patients with acute cerebral infarction. The levels of IMA in each group were compared, and the correlation between level of IMA and infarct volume and NIHSS score was analyzed. Results The level of IMA in patients with acute cerebral infarction was significantly different from that in the control group（ P 〈 0. 01 ） ; There was a significant difference between the small infarction group, the middle infarction group and the large infarction group compared with the control group（P 〈 0. 01 ） ;There was a significant difference in the level of IMA between the small infarction group and the middle infarction group and the large infarction group （P 〈 0. 01 ） ;There was a significant difference in the level of IMA between the large infarction group and the middle infarction group（ P 〈 0. 01 ）. The level of IMA was positively correlated with volume of cerebral infarction（ r = 0. 61, P = 0. 02 ） in patients with acute cerebral infarction, which was positively correlated with NIHSS score （ r = 0. 69,P = 0. 00）. There was a positive correlation between IMA and volume of cerebral infarction, NIHSS score in the small infarction group and the middle infarction group, and the ACB score was positively correlated with the NIHSS score in the large infarction group. Conclusion The level of IMA is positively correlated with the volume of cerebral infarction in patients with acute cerebral infarction,which is of great significanceto judge the patient＇s condition and the early diagnosis and treatment of the disease in clinical.