血清淀粉样蛋白A和β-淀粉样蛋白与急性缺血性脑卒中早期神经功能恶化的相关性研究

Association of serum amyloid A andβ-amyloid with early neurological deterioration in patients with acute ischemic stroke

目的探讨急性缺血性脑卒中(AIS)患者血清淀粉样蛋白A(SSA)、β-淀粉样蛋白(Aβ)的表达变化以及与早期神经功能恶化(END)的相关性。方法选取2016年7月—2018年1月在该院住院及留观的AIS患者203例,根据美国国立卫生研究院卒中量表(NIHSS)评分,分为END组(59例)和非END组(144例)。比较两组患者外周血SAA、Aβ的表达水平,采用多因素Logistic回归分析探讨SAA、Aβ、NIHSS、Alberta卒中早期CT评分(ASPECTS)与END发生的相关性。结果END组患者外周血SAA、Aβ表达水平高于非END组患者(P<0.05)。END组患者NIHSS评分高于非END组患者(P<0.05);ASPECTS评分低于非END组患者(P<0.05)。AIS患者END程度越严重,外周血SAA、Aβ表达水平越高(P<0.05)。多因素Logistic回归分析示,外周血SAA、Aβ表达水平升高是AIS患者发生END的危险因素(P<0.05)。结论急性缺血性脑卒中外周血SAA、Aβ的表达水平升高,可作为早期神经功能恶化发生和严重程度的辅助预测指标。

Objective To investigate the changes in the expression of serum amyloid A(SAA) and β-amyloid(Aβ) in patients with acute ischemic stroke(AIS) and their association with early neurological deterioration(END).Methods A total of 203 patients with AIS who were hospitalized or observed in our hospital from July 2016 to January 2018 were enrolled,and according to National Institutes of Health Stroke Scale(NIHSS) score,they were divided into END group with 59 patients and non-END group with 144 patients.The expression levels of SAA and Aβ in peripheral blood were compared between the two groups,and a multivariate logistic regression analysis was used to investigate the association of SAA,Aβ,NIHSS,and Alberta Stroke Program Early CT Score(ASPECTS) with END.Results The END group had significantly higher expression levels of SAA and Aβ than the non-END group(P<0.05).Compared with the non-END group,the END group had a significantly higher NIHSS score and a significantly lower ASPECTS score(both P<0.05).In the patients with AIS,the degree of END increased with the increases in the expression levels of SAA and Aβ in peripheral blood(P<0.05).The multivariate logistic regression analysis showed that increases in the expression levels of SAA and Aβ were risk factors for END in patients with AIS(P<0.05).Conclusions There are increases in the expression levels of SAA and Aβ in peripheral blood in AIS patients,which can be used as indices to predict the development and severity of END.