急性脑梗死患者血清25(OH)D、hs-CRP及LDL水平变化与TOAST分型的相关性分析

The correlation between TOAST classification and the changes of serum 25(OH)D, hs-CRP and LDL levels in patients with acute cerebral infarction

目的分析急性脑梗死患者血清25-羟维生素D [25-hydroxy vitamin D,25(OH)D]、高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)、低密度脂蛋白(low density lipoprotein,LDL)水平变化与TOAST(trial of org 10172 in acute stroke treatment)分型的关系。方法选取2014年8月至2017年10月本院收治的120例急性脑梗死患者纳入病例组,并进行TOAST分型,选择同期于本院体检的40例健康者纳入对照组,采集两组研究对象空腹肘静脉血测定血清25(OH)D、hs-CRP、LDL水平,分析上述指标与急性脑梗死患者TOAST分型的关系。结果病例组患者血清25(OH)D水平显著低于对照组(P <0.05),hs-CRP、LDL水平均显著高于对照组(P_均<0.05);心源性脑梗死组和其他原因脑梗死组患者25(OH)D水平均显著高于动脉脑梗死组(P_均<0.05),LDL水平显著低于动脉脑梗死组(P <0.05),其他原因脑梗死组患者hs-CRP水平均显著低于动脉脑梗死组和心源性脑梗死组(P_均<0.05);心源性脑梗死组和其他原因脑梗死组患者NIHSS评分均显著低于动脉脑梗死组(P_均<0.05)。急性脑梗死患者血清25(OH)D水平与美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分呈负相关(r=-0.476,P <0.05),其hs-CRP、LDL水平与NIHSS评分均呈正相关(r=0.501、0.301,P_均<0.05)。结论不同TOAST分型的急性脑梗死患者血清25(OH)D、hs-CRP、LDL水平存在一定差异,且患者血清25(OH)D水平与神经功能损伤程度呈负相关,hs-CRP、LDL水平与神经功能损伤程度呈正相关。

Objective To analyze the correlation between 25-hydroxy vitamin D[25(OH)D],high sensitivity C-reactive protein(hs-CRP),low density lipoprotein(LDL)levels and TOAST(trial of org 10172 in acute stroke treatment)classification in patients with acute cerebral infarction.Method A total of 120 patients with acute cerebral infarction admitted to our hospital from August 2014 to October 2017 were selected as case group and TOAST classification was performed.40 healthy people who received physical examination in our hospital during the same period were selected as control group.The fasting elbow venous blood was collected to determine the levels of serum 25(OH)D,hs-CRP and LDL.The relationship between the above indicators and TOAST classification in patients with acute cerebral infarction was analyzed.Result The level of serum 25(OH)D in case group was lower than that in control group(P<0.05),the levels of serum hs-CRP and LDL in case group were higher than those in control group(Pall<0.05).The level of 25(OH)D in cardiogenic cerebral infarction group and other causes cerebral infarction group were significantly higher than those in arterial cerebral infarction group(Pall<0.05),the level of LDL were significantly lower than those in arterial cerebral infarction group(P<0.05).The level of hs-CRP in other causes cerebral infarction group was significantly lower than that in arterial cerebral infarction group and cardiogenic cerebral infarction group(Pall<0.05);the National Institutes of Health Stroke Scale(NIHSS)score of cardiogenic cerebral infarction group and other causes cerebral infarction group were significantly lower than those of arterial cerebral infarction group(Pall<0.05);the level of serum 25(OH)D was negatively correlated with NIHSS score in patients with acute cerebral infarction(r=-0.476,P<0.05),the levels of hs-CRP and LDL were positively correlated with NIHSS scores(r=0.501,0.301,P<0.05).Conclusion Patients with acute cerebral infarction have different TOAST subtype,there are some differences in the levels of serum 25(OH)D,hs-CRP and LDL in patients with acute cerebral infarction,the level of 25(OH)D is negatively correlated with the degree of nerve injuries in patients,the levels of hs-CRP and LDL are positively correlated with the degree of nerve injuries.