ACA、TIMP-1、25(OH)D水平与急性脑梗死患者病情严重程度及预后的关系研究

Study on the relationship between the expression of ACA,TIMP-1,25(OH)D and the severity and prognosis of patients with ACI

目的探究抗心磷脂抗体(ACA)、金属蛋白酶组织抑制因子1(TIMP-1)、25羟基维生素D[25(OH)D]水平与急性脑梗死(ACI)患者病情严重程度及预后的关系。方法选择2015年3月至2018年3月的334例ACI患者作为ACI组,选择同期体检健康者60例作为对照组。使用美国国立卫生研究院卒中量表评分按照患者病情严重程度将ACI患者分为轻度、中度和重度3组。根据神经功能恢复程度分析预后,并分析ACA、TIMP-1、25(OH)D水平与ACI患者病情严重程度及预后的关系。结果ACI组入院时血清中ACA和TIMP-1水平明显高于对照组,差异有统计学意义(P<0.05)。ACI组血清25(OH)D水平明显低于对照组,差异有统计学意义(P<0.05)。中度和重度患者血清ACA、TIMP-1水平明显高于轻度患者,重度患者血清ACA、TIMP-1明显高于中度患者,差异均有统计学意义(P<0.05)。中度和重度患者血清25(OH)D水平明显低于轻度患者,重度患者血清25(OH)D水平明显低于中度患者,差异均有统计学意义(P<0.05)。不同预后的患者血清ACA、TIMP-1、25(OH)D水平差异均有统计学意义(P<0.05),ACA和TIMP-1水平升高与较差的预后有关(P<0.05),而较低水平的25(OH)D与较差的预后有关(P<0.05)。结论ACI患者血清中ACA、TIMP-1水平升高,25(OH)D水平降低,并且高水平的ACA、TIMP-1和低水平的25(OH)D与更严重的病情和更差的预后有关。

Objective To explore the relationship between the expression of anticardiolipin antibody(ACA),tissue inhibitor of metalloproteinases 1(TIMP-1),25 hydroxyvitamin D[25(OH)D]and the severity and prognosis of patients with acute cerebral infarct(ACI).Methods A total of 334 patients with ACI from March 2015 to March 2018 were selected as the research subjects,60 healthy subjects were selected as control group.The NIH Stroke Scale score was used to classify ACI patients as mild,moderate,and severe according to their severity.The prognosis was analyzed according to the degree of neural function recovery.The relationship between the levels of ACA,TIMP-1,25(OH)D and the severity and prognosis of ACI patients were analyzed.Results The serum levels of ACA and TIMP-1 in the ACI group at admission were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The serum 25(OH)D level in the ACI group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The levels of serum ACA and TIMP-1 in moderate and severe patients were significantly higher than those in mild patients,and the level of serum ACA and TIMP-1 in severe patients were significantly higher than those in moderate patients,and the differences were statistically significant(P<0.05).The serum 25(OH)D level in moderate and severe patients were significantly lower than that in the mild patients and the serum 25(OH)D level in the severe patients was significantly higher than that in the moderate patients,and the differences were statistically significant(P<0.05).There were significant differences in serum ACA,TIMP-1,25(OH)D levels in patients with different prognosis(P<0.05),the increase of ACA and TIMP-1 was associated with poor prognosis(P<0.05),lower levels of 25(OH)D was associated with poor prognosis(P<0.05).Conclusion The serum levels of ACA and TIMP-1 increase and 25(OH)D level decrease in ACI patients,and high levels of ACA,TIMP-1 and low level of 25(OH)D are associated with more severe disease and worse prognosis.