GDF-15、apoB与急性脑梗死患者颈动脉狭窄及预后的关系研究

Relationship between the levels of GDF-15 and apoB and carotid artery stenosis and prognosis in patients with acute cerebral infarction

目的研究血清分化生长因子-15(Growth differentiation factor-15,GDF-15)、载脂蛋白B(Apolipoprotein B,apoB)与急性脑梗死患者颈动脉狭窄及预后的关系。方法选择2017年2月至2019年5月本院收治的急性脑梗死患者110例作为研究组,根据颈动脉狭窄程度分为轻度狭窄组(n=32)、中度狭窄组(n=40)、重度狭窄组(n=38);同时选择同期于本院接受健康体检者50例作为对照组。比较各组GDF-15、apoB水平差异,统计患者预后生存情况,分析影响急性脑梗死患者预后的相关因素。结果(1)研究组GDF-15、apoB水平较对照组高(P<0.05)。(2)不同狭窄程度患者GDF-15、apoB水平比较:重度狭窄组>中度狭窄组>轻度狭窄组(P<0.05)。(3)110例急性脑梗死患者生存73例,死亡37例,生存率为66.36%。(4)生存组合并高血压、吸烟、轻度狭窄、侧支循环代偿程度较好和不佳及梗死面积<10cm者较死亡组多,NHISS评分、GDF-15、apoB水平较死亡组低(P<0.05)。(5)NIHSS评分(升高)、GDF水平(异常)、apoB水平(异常)、侧支循环代偿程度(不佳)为影响急性脑梗死患者1年预后的独立危险因素(P<0.05)。结论GDF-15、apoB水平在急性脑梗死患者中随颈动脉狭窄程度显著升高,两者为影响患者预后生存的独立危险因素,可作为预测患者预后不良的指标。

Objective To study the relationship between the levels of GDF-15 and apoB and carotid artery stenosis and prognosis in patients with acute cerebral infarction.Methods A total of 110 patients with acute cerebral infarction admitted to our hospital from February 2017 to May 2019 were selected as the study group.According to the degree of carotid artery stenosis,they were divided into mild stenosis group(n=32)and moderate stenosis group(n=40),severe stenosis group(n=38).At the same time,50 patients who underwent physical examination in our hospital during the same period were selected as the control group.The differences in the levels of GDF-15 and apoB in different subjects were compared,the prognostic survival of the patients was counted,and the relevant factors affecting the prognosis of patients with acute cerebral infarction were analyzed.Results(1)The levels of GDF-15 and apoB in the study group were higher than those in the control group(P<0.05).(2)GDF-15 and apoB levels in patients with different degrees of stenosis were as follows:severe stenosis group>moderate stenosis group>mild stenosis group(P<0.05).(3)In 110 patients with acute cerebral infarction,73 survived and 37 died.The survival rate was 66.36%.(4)There were more patients in the survival group with hypertension,smoking,mild stenosis,better and poorer collateral circulation compensation,and infarct size<10 cm than those in the death group.The NHISS score,GDF-15,and apoB levels were lower than those in the death group(P<0.05).(5)NIHSS score(increased),GDF level(abnormal),apoB level(abnormal),and degree of collateral compensation(poor)were independent risk factors affecting the 1-year prognosis of patients with acute cerebral infarction(P<0.05).Conclusion GDF-15 and apoB levels increase significantly with the severity of carotid artery stenosis in patients with acute cerebral infarction.Both of them are independent risk factors that affect the prognosis of patients and can be used as indicators for predicting poor prognosis of patients.