脑梗死合并高血压病例血清脂肪细胞因子与预后相关性

Correlation between serum adipocytokines and prognosis in patients with cerebral infarction complicated with hypertension

目的探究脑梗死合并高血压病血清脂肪细胞因子与预后的相关性。方法以海口市某医院2018年2月至2021年1月收治的首次发病脑梗死合并高血压患者为研究对象(脑梗死合并高血压组),同时按相同性别、年龄±3岁条件以1∶1匹配同医院脑梗死住院患者、高血压门诊就诊的高血压患者及健康体检中心进行健康体检者,分别设为脑梗死组、高血压组和健康对照组,采集空腹静脉血进行内脂素、脂联素(APN)、网膜素-1(omentin-1)、瘦素(Leptin)水平检测,健康对照组和高血压组以外的2组患者采用超声检测仪测定颈动脉斑块性质。对脑梗死合并高血压患者出院后采用改良Rankin量表(MRS)进行预后评估。采用描述流行病学分析方法对4组人群的相关指标进行分析。结果本研究共纳入脑梗死合并高血压患者248例,男性148例,女性100例,平均年龄(60.96±4.77)岁。脑梗死组、高血压组、健康对照组分别250例、253例、253人,4组人群性别分布、年龄差异均无统计学意义(均P>0.05)。脑梗死合并高血压组血清内脂素、Leptin水平均高于脑梗死组、高血压组、健康对照组,omentin-1、APN水平低于脑梗死组、高血压组、健康对照组(均P<0.01);脑梗死组血内脂素、Leptin水平高于高血压组、健康对照组,omentin-1、APN水平均低于高血压组、健康对照组(均P<0.01);高血压组血内脂素、Leptin水平高于健康对照组,omentin-1、APN水平低于健康对照组(均P<0.01)。脑梗死合并高血压组、脑梗死组易损斑块患者血内脂素、Leptin水平高于稳定斑块患者,omentin-1、APN水平低于稳定斑块患者(均P<0.01)。出院后6个月随访,脑梗死合并高血压组预后不良患者血内脂素、Leptin水平高于预后良好患者,omentin-1、APN水平低于预后良好患者(均P<0.01)。血清omentin-1、APN与颈动脉斑块性质、预后呈负相关,内脂素、Leptin与颈动脉斑块性质、预后呈正相关(P<0.05)。结论脑梗死合并高血压病例血清脂肪细胞因子水平与颈动脉斑块性质、预后密切相关,可为临床后续诊治提供有利依据。

Objective To explore the correlation between serum adipocytokines and prognosis of cerebral infarction complicated with hypertension.Methods The patients with first-onset cerebral infarction complicated with hypertension treated in a hospital in Haikou from February 2018 to January 2021 were selected as the research object(cerebral infarction complicated with hypertension group).At the same time,according to the same gender and age±3 years,the inpatients with cerebral infarction in the same hospital,the hypertensive patients in the hypertension clinic and the physical examination person in the healthy physical examination center were matched 1∶1 as the cerebral infarction group,the hypertension group and the healthy control group.Fasting venous blood was collected to detect the levels of visfatin,adiponectin(APN),omentin-1 and leptin.The properties of carotid artery were measured by ultrasonic detector in the two groups other than the healthy control group and the hypertension group.The prognosis of patients with cerebral infarction complicated with hypertension was evaluated by modified Rankin Scale(MRS).Descriptive epidemiological analysis method was used to analyze the relevant indexes of the four groups.Results A total of 248 patients with cerebral infarction complicated with hypertension were included in this study,including 148 males and 100 females,with an average age of(60.96±4.77)years.There were 250 cases,253 cases and 253 persons in cerebral infarction group,hypertension group and healthy control group respectively.There was no significant difference in gender distribution and age among the four groups(all P>0.05).The levels of blood visfatin and leptin in the cerebral infarction complicated with hypertension group were higher,while the levels of omentin-1 and APN were lower than those in the cerebral infarction group,hypertension group,and healthy control group(all P<0.01).The levels of blood visfatin and leptin in the cerebral infarction group were higher,while the levels of omentin-1 and APN were lower than those in the hypertension group and the healthy control group(all P<0.01).The levels of blood visfatin and leptin were higher,while the levels of omentin-1 and APN were lower than those in the healthy control group(all P<0.01).The levels of blood visfatin and leptin in the vulnerable plaque patients in cerebral infarction complicated with cerebral infarction group and hypertension group were higher,while the levels of omentin-1 and APN were lower than those in stable plaque patients(all P<0.01).Six months after discharge,the levels of blood visfatin and leptin in patients with poor prognosis in cerebral infarction complicated with hypertension group were higher,and the levels of omentin-1 and APN were lower than those in patients with good prognosis(all P<0.01).Serum omentin-1 and APN were negatively correlated with,while visfatin and leptin were positively correlated with the nature and prognosis of carotid plaque(all P<0.05).Conclusion The level of serum adipocytokines in patients with cerebral infarction complicated with hypertension is closely related to the nature and prognosis of carotid plaque,which can provide a favorable basis for clinical follow-up diagnosis and treatment.