不同TOAST分型脑梗死患者血清Hcy、CRP及LDL-C表达及其临床意义

Expression and clinical significance of serum Hcy,CRP and LDL-C in cerebral infarction patients with different TOAST classifications

目的:探究不同TOAST分型脑梗死(CI)患者血清Hcy、CRP及LDL-C水平以及其临床意义。方法:回顾性分析2014年5月~2019年5月在我院收治101例脑梗死患者相关资料,采用TOAST分型标准进行分型,比较不同TOAST分型患者血清Hcy、CRP及LDL-C水平,分析血清学指标与不同TOAST分型之间相关性,预后情况,血清指标与NIHSS评分、mRS评分相关性。结果:不同TOAST分型患者血清Hcy、CRP变化均为大动脉粥样硬化性CI(LAA)组>小动脉闭塞性CI(SAO)组>不明病因与其他病因明确性与其他病因明确性CI(SUE+SOE)组>心源性CI(CE)组,四组间仅CE组与SUE+SOE组之间差异比较没有统计学意义,LAA组患者血清LDL-C水平显著高于其他三组;多元Logistic回归分析结果显示血清指标Hcy、CRP以及LDL-C与TOAST分型均存在相关性,其中三血清学指标与LAA型相关性最强(OR=5.223,3.411,3.117;95%CI:3.023-9.024,2.378-4.892,1.105-8.792);不同TOAST分型患者mRS评分变化均为CE组>SUE+SOE组>LAA组>SAO组,四组间仅CE组与SUE+SOE组之间差异比较没有统计学意义,CE组患者后遗症发生率显著高于LAA组和SAO组,NIHSS评分变化为CE组>SUE+SOE组>LAA组>SAO组,四组间仅CE组与SUE+SOE组之间差异比较没有统计学意义;患者血清Hcy、CRP、LDL-C水平与NIHSS评分正相关,患者血清Hcy、CRP、LDL-C水平与mRS评分之间关系也为正相关。结论:脑梗死患者血清Hcy、CRP、LDL-C表达与TOAST分型存在相关性,其中血清指标与LAA型相关性最强,患者血清学Hcy、CRP、LDL-C指标可用于评估患者预后情况。

Objective To explore levelsof serum Hcy,CRP and LDL-C in cerebral infarction(CI)patients with different TOAST classifications and their and clinical significance.Methods A retrospective analysis was performed on related data of 101 CI patients who were admitted to the hospital from May 2014 to May 2019.The patients were classified by TOAST classification standard.The levels of serum Hcy,CRP and LDL-C were compared among patients with different TOAST classifications.The correlation between serology indexes and different TOAST classifications,prognosis,correlation between serum indexes and NIHSS score,mRS score were analyzed.Results The changes in serum Hcy and CRP in patients with different TOAST classifications were the highest in large-artery atherosclerosis CI(LAA)group,followed by small artery occlusion CI(SAO)group,unknown etiology and other etiologies definition and other etiologies definition CI(SUE+SOE)group and cardiogenic CI(CE)group.There was only no significant difference between CE group and SUE+SOE group.The serum LDL-C level in LAA group was significantly higher than that in the other three groups.The results of multivariate Logistic regression analysis showed that serum indexes Hcy,CRP,and LDL-C were correlated with TOAST classification.The correlation between the three serology indexes and LAA type was the strongest(OR=5.223,3.411,3.117.95%CI:3.023-9.024,2.378-4.892,1.105-8.792).The mRS score of patients with different TOAST classification was the highest in CE group,followed by SUE+SOE group,LAA group and SAO group.There was only no significant significant difference between CE group and SUE+SOE group.The incidence of sequelae in CE group was significantly higher than that in LAA group and SAO group.The changes in NIHSS scores were the highest in CE group,followed by SUE+SOE group,LAA group and SAO group.The levels of serum Hcy,CRP and LDL-C were positively correlated with NIHSS score,and alose positively correlated with mRS score.Conclusion There is correlation between expressions of serum Hcy,CRP,LDL-C in CI patiengs and TOAST classifications.The correlation between serum indexes and LAA type is the strongest.The serology indexes such as Hcy,CRP and LDL-C can be applied to evaluate prognosis of patients.