脂联素在脑梗死不同亚型病程中的变化规律研究

Changes of adiponectin in different subtypes of cerebral infarction

目的探讨不同分子量脂联素在脑梗死不同亚型病程中的变化及相关性。方法选取脑梗死患者182例为病例组。其中脑梗死亚型大动脉粥样硬化性卒中37. 36%,小动脉闭塞性卒中32. 41%,心源性脑栓塞30. 21%。选取来我院进行健康体检的115例非脑梗死患者作为对照组进行实验;观察不同分子量脂联素在不同TOAST分型病程分期中的变化;通过蛋白质免疫印迹检测不同分子量脂联素的表达量;通过酶联免疫吸附试验试剂盒法检测不同分子量脂联素在不同TOAST分型病程分期中的含量。结果冠心病史、糖尿病史、吸烟史和高血压史均与不同分子量脂联素在不同TOAST分型病程中的变化相关(P <0. 05),与对照组相比,脑梗死组中tAPN蛋白水平降低(P <0. 05);与对照组相比,在第1天、第4天、第10天、第15天,大动脉硬化组tAPN水平和HMW降低(P <0. 05),小动脉闭塞组tAPN水平和HMW降低(P <0. 05)。心源性脑栓组tAPN水平和HMW降低,HMW与tAPN密切相关(r=0. 999)。结论 tAPN、HMW与脑梗死密切相关,tAPN、HMW是比MMW和LMW更有效的脑梗死风险的生物标志物,有重要临床价值。

Objective To investigate the changes and correlations of different molecular weight adiponectin in different subtypes of cerebral infarction. Methods 182 patients with cerebral infarction were selected as the case group. Among them,cerebral infarction subtype atherosclerotic stroke was 37. 36%,arteriole occlusive stroke was 32. 41%,and cardiogenic cerebral embolism was 30. 21%. 115 patients with non-cerebral infarction who came to our hospital for physical examination were selected as the control group for the experiment. The changes of adiponectin with different molecular weight in different TOAST stages were observed. The expression of adiponectin with different molecular weight was detected by western blotting. The content of adiponectin with different molecular weight in different TOAST stages was determined by elisa kit.Results History of coronary heart disease,diabetes,smoking and hypertension were all correlated with the changes of adiponectin with different molecular weight in different TOAST types( P < 0. 05). TAPN level was decreased in the cerebral infarction group compared with the control group( P < 0. 05). Compared with the control group,tAPN level and HMW were decreased on day 1,day 4,day 10 and day 15 in the atherosclerosis group( P < 0. 05),and tAPN level and HMW were decreased in the arteriole occlusion group( P < 0. 05). TAPN level and HMW decreased in the cardiac thrombotic group,and HMW was closely related to tAPN( r = 0. 999). Conclusion TAPN and HMW are closely related to cerebral infarction.tAPN and HMW are more effective biomarkers of cerebral infarction risk than MMW and LMW,and have important clinical value.