贾天松;王继涛;周占军;

• 1:濮阳市油田总医院

摘要(Abstract)：

目的探讨血清前白蛋白(PAB)、超敏C反应蛋白(hs-CRP)、氧化型低密度脂蛋白(ox-LDL)及心脏型脂肪酸结合蛋白(H-FABP)与急性脑梗死(ACI)患者神经功能缺损程度的关系。方法选取濮阳市油田总医院100例ACI患者为ACI组,100例非ACI住院患者为对照组,采用ELISA法检测ACI患者入院48 h内的PAB、hs-CRP、ox-LDL及H-FABP水平,并与非ACI组比较,采用Logistic多因素分析PAB、hs-CRP、ox-LDL及H-FABP水平与ACI患者神经功能缺损程度的关系。结果 ACI组hs-CRP(3.89±1.52)mg/L、ox-LDL(77.04±13.28)μg/dL及H-FABP(15.80±3.82)μg/L高于对照组[(0.82±0.31)mg/L、(58.61±8.94)μg/dL、(9.63±2.51)μg/L](P<0.05),ACI组PAB(201.4±29.1)mg/L低于对照组(230.8±33.6)mg/L(P<0.05)。重度组hs-CRP(6.32±1.44)mg/L、H-FABP(19.80±3.11)μg/L高于中度组[(3.44±1.50)mg/L、(16.24±3.67)μg/L]和轻度组[(2.01±1.26)mg/L、(11.49±2.85)μg/L](P<0.05),PAB水平低于中度组(199.4±23.0)mg/L和轻度组(221.6±27.3)mg/L(P<0.05);中度组hs-CRP(2.01±1.26)mg/L、H-FABP(16.24±3.67)μg/L水平高于轻度组[(2.01±1.26)mg/L、(11.49±2.85)μg/L](P<0.05),中度组PAB(199.4±23.0)mg/L低于轻度组(221.6±27.3)mg/L(P<0.05);重度组和中度组的ox-LDL分别为(85.27±11.09)μg/dL、(83.11±10.66)μg/dL,高于对照组(66.09±9.73)μg/dL(P<0.05)。Logistic回归分析模型显示,PAB降低、ox-LDL、H-FABP升高及脑梗死病灶增大是ACI患者神经功能缺损程度严重的独立危险因素(OR值分别为0.559、2.022、1.631、2.565,P<0.05)。结论 PAB、hs-CRP、ox-LDL及H-FABP水平变化能一定程度反映ACI患者神经功能缺损程度,对于指导临床上治疗ACI患者及康复具有一定的价值。

关键词(KeyWords)： 急性脑梗死;前白蛋白;超敏C反应蛋白;氧化型低密度脂蛋白;心脏型脂肪酸结合蛋白;神经功能缺损

Abstract:

Keywords:

基金项目(Foundation): 2019年度河南省医学科技攻关计划省部共建项目（编号：SB201901061）

作者(Authors): 贾天松;王继涛;周占军;

参考文献(References)：

• [1]JAFFE T A,WINSLOW J,ZHANG Y,et al.Automated Early Identification of an Excessive Air-in-Oil X-ray Tube Artifact That Mimics Acute Cerebral Infarct[J].JComput Assist Tomogr,2019,43(1):18-21.DOI:10.1097/RCT.0000000000000770.
• [2]FARKAS A,SCHLAKMAN B,KHAN M,et al.Glioblastoma Presenting with Acute Middle Cerebral Artery Territory Infarct[J].J Stroke Cerebrovasc,2018,27(7):e113-e114.DOI:10.1016/j.jstrokecerebrovasdis.2018.2.019.
• [3]LU Y K,YANG H Y,LIU X Z,et al.Effect of modified Buyang Huanwu Decoction on hemorrhagic transformation after rt-PA intravenous thrombolysis in patients with super early cerebral infarction[J].Zhongguo Zhong Yao Za Zhi,2019,44(8):1696-1703.DOI:10.19540/j.cnki.cjcmm.20181204.012.
• [4]LI Q,DING S,WANG Y M,et al.Age-associated alteration in Th17 cell response is related to endothelial cell senescence and atherosclerotic cerebral infarction[J].Am J Transl Res,2017,9(11):5160-5168.
• [5]RIZOS T,BARTSCH A J,JOHNSON T D,et al.Voxelwise distribution of acute ischemic stroke lesions in patients with newly diagnosed atrial fibrillation:Trigger of arrhythmia or only target of embolism?[J].PLo S ONE,2017,12(5):e0177474.DOI:10.1371/journal.pone.0177474.
• [6]CSAKO G,ZWEIG M H,GLICKMAN J,et al.Direct and indirect techniques for free thyroxin compared in patients with nonthyroidal illness.II.Effect of prealbumin,albumin,and thyroxin-binding globu Lin[J].Clin Chem,1989,35 (8):1655-1662.DOI:10.1093/clinchem/35.8.1655.
• [7]SHERRY B,JACK R M,WEBER A,et al.Reference interval for prealbumin for children two to 36 months old[J].Clin Chem,1988,34(9):1878-1880.DOI:10.1093/clinchem/34.9.1875.
• [8]WANG R,ZENG J,WANG F,et al.Risk factors of hemorrhagic transformation after intravenous thrombolysis with rt-PAB in acute cerebral infarction[J].QJM-Int JMed,2018,34(5):323-326.
• [9]贺时磊，徐雯雯，刘学昌.血清CXCL9及血小板参数与老年脑梗死患者神经功能缺损的相关性[J].中国实用神经疾病杂志，2020,23(18):1602-1608.DOI:10.12083/SYSJ.2020.18.012.
• [10]SUN P,LU L,CHEN J,et al.AMPKα，hs-CRP and FcγR in diabetic nephropathy and drug intervention[J].Exp Ther Med,2018,15(6):4659-4664.DOI:10.3892/etm.2018.6034
• [11]WANG L,ZHAO H,ZHAI Z Z,et al.Protective effect and mechanism of ginsenoside Rg1 in cerebral ischaemia-reperfusion injury in mice[J].Biomed Pharmacother,2018,99:876-882.DOI:10.1016/j.biopha.2018.01.136.
• [12]SUN W,LIN Y,CHEN L,et al.Legumain suppresses Ox LDL-induced macrophage apoptosis through enhancement of the autophagy pathway[J].Gene,2018,652(12):16-24.DOI:10.1016/j.gene.2018.02.012.
• [13]YE T,ZHU L,TANG Q,et al.Effects of electroacupuncture preconditioning on cerebral infarct volume and contents of TNF-α，IL-10 in serum of rats after cerebral ischemia-reperfusion injury[J].Zhongguo Zhen Jiu,2017,37(10):1093-1097.DOI:10.13703/j.0255-2930.2017.10.017.
• [14]ZHU L,YE T,TANG Q,et al.Exercise Preconditioning Regulates the Toll-Like Receptor 4/Nuclear Factor-κBSignaling Pathway and Reduces Cerebral Ischemia/Reperfusion Inflammatory Injury:A Study in Rats[J].JStroke Cerebrovasc Dis,2016,25(11):2770-2779.DOI:10.1016/j.jstrokecerebrovasdis.2016.07.033.
• [15]余年，许雯雯，林兴建.丁苯酞治疗急性脑梗死患者轻度认知功能障碍的随访研究[J].中国实用神经疾病杂志，2019,22(16):1751-1755.DOI:10.12083/SYSJ.2019.16.294.
• [16]WU Q,QU J,YIN Y,et al.Morning hypertension is a risk factor of macrovascu Lar events following cerebral infarction[J].Medicine,2018,97(34):2013-2016.
• [17]LI M,WU J,CHEN X,et al.Symptomatic and silent cerebral infarction following surgical clipping of unruptured intracranial aneurysms:incidence,risk factors,and clinical outcome[J].Neurosurg Rev,2018,41(2):675-682.DOI:10.1007/s10143-017-0913-1.
• [18]YU J,ZENG J,CHEUNG R T,et al.Intracerebroventricular injection of epidermal growth factor reduces neurological deficit and infarct volume and enhances nestin expression following focal cerebral infarction in adult hypertensive rats[J].Clin Exp Pharmacol Physiol,2009,36(5/6):539-546.DOI:10.1111/j.1440-1681.2008.05105.x.
• [19]CHANG H,LU Z.The expression of serummi R-151a-3p in patients with acute cerebral infarction and its correlation with pro-inflammatory factors[J].Zhonghua Wei Zhong Bing Ji Jiu Yi Xue,2016,28(3):272-276.
• [20]ZOU Y S,YAN G,CHENG R,et al.Diagnostic values of prealbumin and retinol-binding protein for liver damage caused by different degrees of neonatal asphyxia[J].Zhongguo Dang Dai Er Ke Za Zhi,2017,19(3):75-82.DOI:10.7499/j.issn.1008-8830.2017.03.017.
• [21]ZHU P,MIAO W,GU F,et al.Changes of serum and peritoneal inflammatory mediators in laparoscopic radical resection for right colon carcinoma[J].J Minim Access Surg,2018,15(2):210-211.DOI:10.4103/jmas.JMAS_217_17.
• [22]TARKKINEN P,PALENIUS T,L?VGREN T.Ultrarapid,Ultrasensitive One-Step Kinetic Immunoassay for C-Reactive Protein (CRP) in Whole Blood Samples:Measurement of the Entire CRP Concentration Range with a Single Sample Dilution[J].Clin Chem,2002,48(2):269-277.
• [23]STANCEL N,CHEN C C,E LIANG Y K,et al.Interplay between CRP,Atherogenic LDL,and LOX-1 and Its Potential Role in the Pathogenesis of Atherosclerosis[J].Clin Chem,2016,62(2):320-327.DOI:10.1373/clinchem.2015.243923.
• [24]PELSERS M M,HANHOFF T,VAN DER VOORT D,et al.Brain-and Heart-Type Fatty Acid-Binding Proteins in the Brain:Tissue Distribution and Clinical Utility[J].Clin Chem,2004,50(9):1568.DOI:10.1373/clinchem.2003.030361.
• [25]沈雷，张保朝，付国惠.老年急性脑梗死患者Fibulin-5mi R-210水平与神经功能缺损的相关性研究[J].中国实用神经疾病杂志，2020,23(16):1418-1423.DOI:10.12083/SYSJ.2020.16.025.