脑梗死患者血清因子蛋白水平与神经功能缺损的关系

The relationship between serum factor,protein and neurological deficit in patients with cerebral infarction

目的探讨血清前白蛋白(PAB)、超敏C反应蛋白(hs-CRP)、氧化型低密度脂蛋白(ox-LDL)及心脏型脂肪酸结合蛋白(H-FABP)与急性脑梗死(ACI)患者神经功能缺损程度的关系。方法选取濮阳市油田总医院100例ACI患者为ACI组,100例非ACI住院患者为对照组,采用ELISA法检测ACI患者入院48 h内的PAB、hs-CRP、ox-LDL及H-FABP水平,并与非ACI组比较,采用Logistic多因素分析PAB、hs-CRP、ox-LDL及H-FABP水平与ACI患者神经功能缺损程度的关系。结果ACI组hs-CRP(3.89±1.52)mg/L、ox-LDL(77.04±13.28)μg/dL及H-FABP(15.80±3.82)μg/L高于对照组[(0.82±0.31)mg/L、(58.61±8.94)μg/dL、(9.63±2.51)μg/L](P<0.05),ACI组PAB(201.4±29.1)mg/L低于对照组(230.8±33.6)mg/L(P<0.05)。重度组hs-CRP(6.32±1.44)mg/L、H-FABP(19.80±3.11)μg/L高于中度组[(3.44±1.50)mg/L、(16.24±3.67)μg/L]和轻度组[(2.01±1.26)mg/L、(11.49±2.85)μg/L](P<0.05),PAB水平低于中度组(199.4±23.0)mg/L和轻度组(221.6±27.3)mg/L(P<0.05);中度组hs-CRP(2.01±1.26)mg/L、H-FABP(16.24±3.67)μg/L水平高于轻度组[(2.01±1.26)mg/L、(11.49±2.85)μg/L](P<0.05),中度组PAB(199.4±23.0)mg/L低于轻度组(221.6±27.3)mg/L(P<0.05);重度组和中度组的ox-LDL分别为(85.27±11.09)μg/dL、(83.11±10.66)μg/dL,高于对照组(66.09±9.73)μg/dL(P<0.05)。Logistic回归分析模型显示,PAB降低、ox-LDL、H-FABP升高及脑梗死病灶增大是ACI患者神经功能缺损程度严重的独立危险因素(OR值分别为0.559、2.022、1.631、2.565,P<0.05)。结论PAB、hs-CRP、ox-LDL及H-FABP水平变化能一定程度反映ACI患者神经功能缺损程度,对于指导临床上治疗ACI患者及康复具有一定的价值。

Objective To explore the relationship between serum PAB,hs-CRP,ox-LDL and H-FABP and the degree of neuro⁃logical deficit in patients with ACI.Methods A total of 100 ACI patients in our hospital were selected as the ACI group and 100 non-ACI inpatient control groups.The levels of PAB,hs-CRP,ox-LDL,and H-FABP within 48 hours after admission of ACI patients were detected by ELISA and compared with the non-ACI group For comparison,Logistic multi-factor analysis was used to explore the relationship between PAB,hs-CRP,ox-LDL and H-FABP levels and the degree of neurological deficits in ACI patients.Results The hs-CRP(3.89±1.52)mg/L,ox-LDL(77.04±13.28)μg/dL and H-FABP(15.80±3.82)μg/L of the ACI group were higher than those of the control group((0.82±0.31)mg/L,(58.61±8.94)μg/dL,(9.63±2.51)μg/L)(P<0.05),the PAB(201.4±29.1)mg/L of the ACI group was lower than that of the control group(230.8±33.6)mg/L(P<0.05).The severe group hs-CRP(6.32±1.44)mg/L,H-FABP(19.80±3.11)μg/L were higher than the moderate group((3.44±1.50)mg/L,(16.24±3.67)μg/L)and mild group((2.01±1.26)mg/L,(11.49±2.85)μg/L)(P<0.05),the PAB level was lower than the moderate group(199.4±23.0)mg/L and the mild group(221.6±27.3)mg/L(P<0.05);the levels of hs-CRP(2.01±1.26)mg/L and H-FABP(16.24±3.67)μg/L in the moderate group were higher than those in the mild group((2.01±1.26)mg/L,(11.49±2.85)μg/L)(P<0.05),PAB(199.4±23.0)mg/L in the moderate group was lower than that in the mild group(221.6±27.3)mg/L(P<0.05);the ox-LDL of the severe group and the moderate group were(85.27±11.09)μg/dL and(83.11±10.66)μg/dL respectively higher than the control group(66.09±9.73)μg/dL(P<0.05).Logis⁃tic regression analysis model showed that PAB decrease,ox-LDL,H-FABP increase,and cerebral infarction lesion enlargement were independent risk factors for the severity of neurological deficits in ACI patients(OR values were 0.559,2.022,1.631,2.565,respective⁃ly,P<0.05).Conclusion The changes of PAB,hs-CRP,ox-LDL and H-FABP levels can reflect the degree of neurological deficits in ACI patients to a certain extent,and have certain value for guiding clinical treatment and rehabilitation of ACI patients.