急性缺血性脑卒中患者血清A-FABP、CXCL12水平变化及临床意义

Changes of serum A-FABP and CXCL12 levels in patients with acute ischemic stroke and its clinical significance

目的探讨急性缺血性脑卒中(AIS)患者血清脂肪细胞型脂肪酸结合蛋白(A-FABP)、趋化因子CXCL12水平变化及临床意义。方法选取2016年5月至2017年5月青海省西宁市第三人民医院收治的AIS患者110例作为研究组,选取同期于该院进行健康体检者80例作为对照组。比较两组研究对象血清AFABP与CXCL12水平的差异,评价不同临床与病理特征及不同预后AIS患者血清A-FABP与CXCL12水平。结果研究组患者血清A-FABP与CXCL12水平均显著高于对照组,差异均有统计学意义(P<0.05)。AIS患者中梗死面积>4cm、美国国立卫生院神经功能缺损量表(NIHSS)评分>15分、格拉斯哥昏迷(GCS)评分>8分者血清A-FABP与CXCL12水平均显著高于梗死面积≤4cm、NIHSS评分≤15分、GCS评分≤8分者,差异均有统计学意义(P<0.05)。随访3个月,经改良Rankin量表(MRS)评价,AIS患者中预后良好82例(74.55%),预后不良28例(25.45%),预后不良患者血清A-FABP与CXCL12水平均显著高于预后良好者,差异均有统计学意义(P<0.05)。血清A-FABP、CXCL12水平与AIS患者梗死面积、NIHSS评分、GCS、MRS评分呈正相关。结论老年AIS患者血清A-FABP、CXCL12水平升高,且血清A-FABP、CXCL12水平与其病变严重程度、预后情况有关。

Objective To investigate the changes and clinical significance of serum adipocyte fatty acid binding protein（A-FABP）and chemokine CXCL12 in patients with acute ischemic stroke（AIS）.Methods110 patients with AIS admitted to the Third People′s Hospital of Xining City,Qinghai Province,from May2015 to May 2017,were selected as the study group,and 80 health examinees from the Third People′s Hospital of Xining City,Qinghai Province,during the same period,were selected as the control group.The differences of serum A-FABP and CXCL12 levels between the two groups were compared,and the serum A-FABP and CXCL12 levels in AIS patients with different clinical and pathological characteristics and different prognosis were evaluated.Results The serum A-FABP and CXCL12 levels in the study group were significantly higher than those in the control group（P0.05）.The levels of serum A-FABP and CXCL12 in AIS patients with infarct size4 cm,NIHSS score15,Glasgow coma score8 were significantly higher than those in AIS patients with infarct size4 cm,NIHSS score15,GCS score8,and the differences were statistically significant（P0.05）.The results of follow-up for 3 months showed that 82 cases（74.55%）had good prognosis and 28 cases（25.45%）had poor prognosis.The serum A-FABP and CXCL12 levels in patients with poor prognosis were significantly higher than those with good prognosis（P0.05）.The levels of serum A-FABP and CXCL12 were positively correlated with infarct size,NIHSS score,GCS and MRS score of AIS patients.Conclusion The levels of serum A-FABP and CXCL12 in elderly patients with AIS increased,and the levels of serum A-FABP and CXCL12 were related to the severity of the disease and prognosis.