高血压合并脑梗死患者血清淀粉样蛋白A、脑源性神经营养因子水平变化及意义

Changes of serum SAA and BDNF levels in patients with hypertension complicated with cerebral infarction and its significance

目的探讨高血压合并脑梗死患者血清淀粉样蛋白A(SAA)、脑源性神经营养因子(BDNF)水平变化及意义。方法收集海南医学院第一附属医院2018年1月~2020年12月收治的116例高血压合并脑梗死患者为研究组,同期60例单纯高血压患者为对照组。对比两组患者血清SAA、BDNF水平差异,分析两项指标水平与高血压合并脑梗死患者神经损伤程度、梗死面积及预后的关系,评估血清SAA、BDNF水平对高血压合并脑梗死患者预后的预测价值。结果与对照组相比,研究组血清SAA水平明显升高,而血清BDNF水平则显著降低,差异有统计学意义(P<0.05)。随着神经损伤程度的加重或梗死面积增大,血清SAA水平逐渐升高,而血清BDNF则逐渐降低,差异有统计学意义(P<0.05)。预后不良患者血清SAA水平高于预后良好组,血清BDNF水平则显著低于预后良好组,差异有统计学意义(P<0.05)。血清SAA水平与NIHSS评分、梗死面积、mRS评分呈现正相关,而血清BDNF水平与NIHSS评分、梗死面积、mRS评分则呈负相关关系,差异有统计学意义(P<0.05)。血清SAA与BDNF联合检测评估高血压脑梗死患者预后的曲线下面积为0.868,灵敏度为82.9%,特异度为80.0%。结论高血压合并脑梗死患者血清SAA、BDNF水平与神经损伤程度、脑梗死面积及预后密切相关,联合检测两项指标有助于早期评估患者预后情况。

Objective To investigate the changes of serum amyloid A(SAA)and brain-derived neurotrophic factor(BDNF levels in patients with hypertension complicated with cerebral infarction and its significance.Methods A total of 116 patients with hypertension complicated with cerebral infarction admitted to our hospital from January 2018 to December 2020 were enrolled as the study group,and 60 patients with simple hypertension were enrolled as the control group.The levels of SAA and BDNF were compared between the two groups.The relationship between the levels of the two indexes and the degree of nerve injury,infarct size and prognosis of patients with hypertension complicated with cerebral infarction were analyzed.The prognostic values of serum SAA and BDNF levels in patients with hypertension complicated with cerebral infarction were evaluated.Results Compared with the control group,the serum SAA level in the study group was significantly increased,while the serum BDNF level was significantly decreased(P<0.05).With the aggravation of nerve injury or the increase of infarct area,the level of SAA increased gradually,while serum BDNF decreased gradually(P<0.05).The level of SAA in patients with poor prognosis was higher than patients with good prognosis,and the serum BDNF level was significantly lower than patients with good prognosis(P<0.05).The level of SAA was positively correlated with NIHSS score,infarction area and mRS score,while the BDNF level was negatively correlated with NIHSS score,infarction area and mRS score(P<0.05).The area under the curve of SAA combined with BDNF was 0.868,the sensitivity was 82.9%,and the specificity was 80.0%.Conclusions The levels of SAA and BDNF in patients with hypertension complicated with cerebral infarction are closely related to the degree of nerve injury,the area of cerebral infarction and the prognosis.Combined detection of the two indicators is helpful to assess the prognosis of patients in early stage.