血清apelin水平与脑白质高信号的相关性研究

Correlation between serum apelin level and white matter hyperintensities

目的通过检测脑白质高信号（WMH）患者血清apelin水平，探讨其与WMH的相关性。方法对300例脑卒中高危患者行头颅MRI检查，根据WMH评分将患者分为0级组（72例）、1级组（101例）、2级组（65例）和3级组（62例）。收集患者的一般临床资料、高血压病和糖尿病病史、实验室检测指标，采用酶联免疫吸附试验测定患者血清apelin水平并进行比较，分析其与WMH严重程度的相关性。结果4组患者的年龄、高血压病史、同型半胱氨酸（Hcy）、纤维蛋白原（FIB）、超敏c反应蛋白（hs—CRP）及甘油三酯（TG）比较差异均有统计学意义，其中年龄、高血压病史、Hcy、FIB、hs—CRP与WMH分级均呈正相关（P〈0．05）。除2级组与3级组apelin水平比较差异无统计学意义（P〉0．05），余各组间apelin水平两两比较差异均有统计学意义（P〈0．05）。血清apelin水平与WMH分级呈正相关（r=0．671，P〈0．001）。Logistic回归分析结果显示，随着血清apelin水平升高，发生2级、3级WMH的风险分别升高至1．002倍（95％CI1．000～1．003，P=0．035）、1．002倍（95％CI1．000～1．003，P=0．026）。结论血清apelin水平与WMH分级具有相关性，且与中重度WMH独立相关。

Objective To explore the correlation of serum apelin level with white matter hyperintensities（WMH）. Methods A total of 300 patients were divided into 4 groups by the results of MRI,which included group grade 0 （72 cases）, grade 1 （ 101 cases ）, grade 2 （ 65 cases ） and grade 3 （62 cases）. The basic clinical data, medical history of hypertension and diabetes mellitus,laboratory tests results were collected and analyzed. Serum apelin level was detected by enzyme linked immunosorbent assay（ELISA） and compared among 4 groups. Correlation between apelin and WMH were analyzed. Results There were statistical differences among 4 groups on age, hypertension history, homocysteine （ Hcy）, fibrinogen （ FIB ）, hyper-sensitive C-reactive protein （hs-CRP） and triglyceride levels. However, only age, hypertension history, Hcy, FIB and hs-CRP were associated with the classification of WMH （P 〈0.05）. There were statistical differences between any two groups except for group grade 2 versus group grade 3 （ P 〈 0.05 ）. Serum apelin level was positively associated with the grading of WMH （r = 0.671 ,P 〈 0. 001 ）. In Logistic regression analysis, patients with the increased level of serum apelin had 1. 002 （95 % CI 1. 000-1. 003, P = O. 035 ） and 1. 002 （ 95 % CI 1. 000-1. 003, P = 0. 026） times risk of developing into grade 2 and 3 WMH respectively. Conclusion Serum apelin level is associated with the grading of WMH and is independently associated with moderate and severe WMH.