急性脑梗死合并高尿酸血症患者血清几丁质酶-3样蛋白-1和高敏C反应蛋白水平变化及临床意义

Changes and clinical significances of serum YKL-40 and high sensitivity C-reactive protein in acute cerebral infarction complicated with hyperuricemia

目的探讨急性脑梗死合并高尿酸血症(hyperuricemia,HUA)患者血清几丁质酶-3样蛋白-1(chtinase-3-like-1protein,YKL-40)、高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)水平变化及临床意义。方法急性脑梗死患者120例,根据血尿酸水平分为脑梗死合并HUA组62例和单纯脑梗死组58例;同期体检健康者50例为对照组。采用ELISA法测定3组血清YKL-40水平,采用免疫散射比浊法测定血清hs-CRP水平,并进行组间比较;分析急性脑梗死合并HUA组血尿酸水平与血清YKL-40、hs-CRP水平的相关性。结果单纯脑梗死组和脑梗死合并HUA组血清YKL-40[(182.13±40.42)、(273.60±55.88)μg/L]、hs-CRP水平[(9.88±2.37)、(15.89±3.40)mg/L]水平高于对照组[(98.65±29.11)μg/L、(3.02±0.64)mg/L](P<0.01),脑梗死合并HUA组高于单纯脑梗死组(P<0.01);脑梗死合并HUA组患者血尿酸水平[(488.25±62.77)μmol/L]高于单纯脑梗死组[(368.80±61.22)μmol/L]和对照组[(350.62±52.73)μmol/L](P<0.05),单纯脑梗死组与对照组比较差异无统计学意义(P>0.05);脑梗死合并HUA组血尿酸水平与血清YKL-40、hs-CRP水平均呈正相关(r=0.522,P<0.001;r=0.483,P<0.001)。结论YKL-40及hs-CRP可能参与了急性脑梗死的发生、发展,且血尿酸水平升高可加重急性脑梗死患者机体炎性反应。

Objective To explore the changes and significances of the serum levels of chtinase-3-like-1 protein(YKL-40)and high sensitivity C-reactive protein(hs-CRP)in patients with acute cerebral infarction(ACI)complicated with hyperuricemia(HUA).Methods A total of 120 patients with ACI were divided into two groups according to whether HUA was complicated with,ACI+HUA group(n=62)and ACI group(n=58),and another 50 healthy volunteers were as controls(control group).The serum level of YKL-40 was detected by ELISA,and the level of hs-CRP was detected by immune scatter turbidity,which were compared among groups.The correlation of serum uric acid with serum YKL-40 and hs-CRP were analyzed in ACI+HUA group.Results The serum levels of YKL-40((182.13±40.42),(273.60±55.88)μg/L)and hs-CRP((9.88±2.37),(15.89±3.40)mg/L)in ACI group and ACI+HUA group were significantly higher than those in control group((98.65±29.11)μg/L,(3.02±0.64)mg/L)(P<0.01),and in ACI+HUA group than those in ACI group(P<0.01).The serum uric acid level was significantly higher in ACI+HUA group((488.25±62.77)μmol/L)than that in ACI group((368.80±61.22)μmol/L)and control group((350.62±52.73)μmol/L)(P<0.05),and showed no significant difference between ACI group and control group(P>0.05).The serum uric acid level was positively correlated with YKL-40(r=0.522,P<0.001)and hs-CRP(r=0.483,P<0.001)in ACI+HUA group.Conclusion YKL-40 and hs-CRP may participate in the development and progression of ACI,and the increased serum uric acid level may aggravate the inflammatory reaction in patients with ACI.