Hcy、Cys-c、NT-proBNP、D-二聚体在急性缺血性脑卒中患者血浆中变化意义研究

Significance of Hcy, Cys-c, NT-proBNP and D-dimer in plasma in patients with acute ischemic stroke

目的 探究同型半胱氨酸(Hcy)、胱抑素C(Cys-c)、N末端-脑钠肽前体(NT-proBNP)、D-二聚体在急性缺血性脑卒中患者血浆中变化意义.方法 选取90例急性缺血性脑卒中患者作为观察组,选取同期体检科健康体检者40例作为对照组.根据美国国立卫生研究所脑卒中量表(NIHSS)将观察组患者分为轻度组(NIHSS评分0~15分,40例)、中度组(NIHSS评分16~30分,26例)、重度组(NIHSS评分31~45分,24例).比较4组研究对象入院第2天Hcy、Cys-c、NT-proBNP、D-二聚体水平及炎性因子水平(CRP、TNF-α、IL-1β、IL-6).结果 观察组Hcy、Cys-c、NT-proBNP、D-二聚体、CRP、TNF-α、IL-1β、IL-6水平均较对照组高,差异有统计学意义(P<0.05).重度组患者Hcy、Cys-c、NT-proBNP、D-二聚体水平高于轻度组、中度组、对照组(P<0.05),中度组Hcy、Cys-c、NT-proBNP、D-二聚体水平高于轻度组、对照组(P<0.05),轻度组Hcy、Cys-c、NT-proB?NP、D-二聚体水平高于对照组(P<0.05).重度组患者CRP、TNF-α、IL-1β、IL-6水平高于轻度组、中度组、对照组(P<0.05),中度组IL-6水平高于轻度组、对照组(P<0.05),中度组CRP水平高于对照组(P<0.05),轻度组IL-6水平高于对照组(P<0.05).相关性分析结果显示,NIHSS评分与Hcy、Cys-c、NT-proBNP、D-二聚体、炎症因子均呈正相关(P<0.05),IL-6水平与Hcy、Cys-c、NT-proBNP、D-二聚体均呈正相关(P<0.05).结论 急性缺血性脑卒中患者外周血中Hcy、Cys-c、NT-proBNP、D-二聚体水平升高,且与脑卒中严重程度密切相关.

Objective To investigate the significance of homocysteine(Hey),cystatin C(Cys-c),N-terminal pro-brain natriuretic peptide(NT-proBNP)and D-dimer in acute ischemic stroke patients.Methods Ninety patients with acute ischemic stroke were selected as the observation group.Forty healthy subjects from the physical examination depart­ment of our hospital were selected as the control group.According to the National Institutes of Health Stroke Scale(NI­HSS),the observation group was divided into mild group(NIHSS score 0~15 points,40 cases),moderate group(NIHSS score 16〜30 points,26 cases)and severe group(NIHSS score 31〜45 points,24 cases).The levels of Hcy,Cys-c,NT-proBNP,D-dimer and inflammatory factors(CRP,TNF-α,IL-1β,IL-6)were compared on the 2nd day after admis­sion in 4 groups.Results The levels of Hey,Cys-c,NT-proBNP,D-dimer,CRP,TNF-α,IL-1β and IL-6 in the obser­vation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The levels of Hey,Cys-c,NT-proBNP.D-dimer,CRP,TNF-α,IL-1β and IL-6 in the severe group were higher than those in the mild group,the moderate group and the control group(P<0.05),and the levels of Hey,Cys-c,NT-proBNP,D-di­mer in moderate group were higher than those of the mild group and the control group(P<0.05).The levels of Hey,Cys-c,NT-proBNP and D-dimer in the mild group were higher than those in the control group(P<0.05).The level of IL-6 in the moderate group was higher than that in the mild group and the control group(P<0.05),the CRP level in the mod­erate group was higher than that in tht"control group(P<0.05),and the IL-6 level in the mild group was higher than that in the control group(P<0.05).Correlation analysis showed that NIHSS score was positively correlated with Hey,Cys-c,NT-proBNP,D-dimer and inflammatory factors(P<0.05),IL-6 level and Hey,Cys-c,NT-proBNP.D-dimer was positively correlated(P<0.05).Conclusion The levels of Hey,Cys-c,NT-proBNP and D-dimer in peripheral blood of patients with acute ischemic stroke are elevated and are closely related to the severity of stroke.