脑梗死患者血清腱糖蛋白C变化及临床意义

Serum tenascin-C level and its clinical significance in ischemic stroke patients

目的分析急性脑梗死患者血清腱糖蛋白C(TNC)变化及临床意义,探讨其在脑缺血性炎性病理损伤中的可能机制。方法选择发病<1d的符合入选标准的急性脑梗死患者38例为试验组,同时收集年龄和性别相匹配的同期健康体检者28例为对照组,试验组发病第1天,对照组体检时抽血,采用Luminex法测定血清TNC水平。试验组随机选24例患者进行血清TNC水平动态观察(发病第5天抽血复查)。还分析试验组TOAST病因分型为大动脉粥样硬化型脑梗死的20例患者中,不稳定斑块8例和稳定斑块12例血清TNC水平。结果试验组血清TNC水平显著高于对照组[(594.17±158.14)ng/L vs(504.98±110.80)ng/L,P<0.05],差异有统计学意义。试验组24例患者发病第5天较第1天血清TNC水平明显下降[(632.61±165.27)ng/L vs(657.90±133.02)ng/L,P<0.05],且均明显高于对照组(P<0.05)。大动脉粥样硬化型患者不稳定斑块血清TNC水平明显高于稳定斑块[(684.90±95.45)ng/L vs(519.21±149.69)ng/L,P<0.05],差异有统计学意义。结论急性脑梗死患者血清TNC水平升高,可能参与了脑缺血病理损伤及神经修复。

Objective To study the serum tenascin-C（TNC）level and its clinical significance in ischemic stroke patients.Methods Thirty-eight acute ischemic stroke（AIS）patients served as an experimental group and 28 age-and gender-matched subjects undergoing physical examination served as a control group in this study.Blood samples were taken to measure their serum TNC level by Luminex assay.The serum TNC level in 24 patients of experimental group was measured again on day 5 after onset of ischemic stroke.The etiology of TOAST was classified as large atherosclerotic ischemic stroke in 20 patients,unstable plaques in 8 patients and stable plaques in 12 patients of experimental group.Results The serum TNC level was significantly higher in experimental group than in control group（594.17±158.14 ng/L vs 504.98±110.80 ng/L,P〈0.05）and was significantly lower on day 5 than on day 1 after onset of ischemic stroke in 24 patients of experimental group（632.61±165.27 ng/L vs 657.90±133.02 ng/L,P〈0.05）.The serum TNC level was significantly higher in atherosclerotic ischemic stroke patients with unstable plaques than in those with stable plaques（684.90±95.45 ng/Lvs 519.21±149.69 ng/L,P〈0.05）.Conclusion Elevated serum TNC level is possibly involved in cerebral ischemia,pathological injury and nerve repair in AIS patients.