摘要
目的探讨血清淀粉样蛋白A(serum amyloid A,SAA)、触珠蛋白(haptoglobin,HP)水平与急性脑梗死病情严重程度及预后的关系。方法选取急性脑梗死患者574例,检测血清中SAA和HP的水平。采用美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分将脑梗死患者入院时严重程度分为轻度组(<5分)、中度组(5~15分)、重度组(≥16分)。比较SAA、HP水平在轻度组、中度组、重度组中的差异。出院后随访3个月,用改良Rankin量表(modified Rankin scale,mRS)评估急性脑梗死患者3个月预后,根据mRS评分将患者分为良好预后组(≤2分)和不良预后组(> 2分);探讨SAA、HP水平与脑梗死预后的关系。结果不同严重程度的脑梗死患者SAA水平有差异,重度组SAA水平高于中度组、轻度组(P <0. 05),中度组SAA水平高于轻度组(P <0. 05);但三组的HP水平差异无统计学意义(P> 0. 05)。良好预后组与不良预后组的年龄、吸烟史及SSA水平差异均有统计学意义(均P <0. 05),两组的性别、高血压、糖尿病、高血脂、饮酒史及HP水平比较差异均无统计学意义(均P> 0. 05)。多因素Logistic回归分析显示年龄、吸烟史、SAA水平是急性脑梗死患者3个月预后不良的独立危险因素(均P <0. 05)。结论 SAA水平、年龄与吸烟史是急性脑梗死患者3个月预后不良的独立危险因素;SAA水平可以考虑作为急性脑梗死病情严重程度的预测指标。
Objective To investigate the correlation of serum amyloid A( SAA) and haptoglobin( HP) levels with the severity and prognosis of acute cerebral infarction. Methods 574 patients with acute cerebral infarction were enrolled in the study.The levels of SAA and HP in serum were measured by dual-ray immunoturbidimetry. The National Institutes of Health Stroke Scale( NIHSS) score was used to divided the patients into mild( < 5 points),moderate( 5 ~ 15 points),and severe groups( ≥16 points). The levels of SAA and Hp in the mild,moderate,and severe groups was compared. All patients were followed up for 3 months after discharge and assessed with a modified Rankin scale( mRS). According to the mRS score,the patients were divided into a good prognosis group( ≤2 points) and a poor prognosis group( > 2 points). The correlation of SAA and Hp levels with prognosis of acute cerebral infarction was investigated. Results The SAA levels of patients with different severity of cerebral infarction were different. The SAA level in the severe group was higher than that in the moderate group and the mild group( P < 0. 05). The SAA level in the moderate group was higher than that in the mild group( P < 0. 05). The level of HP in the 3 groups was not no statistical different( F = 0. 559,P > 0. 05). There was significant difference in age,smoking history and SAA between the good prognosis group and the poor prognosis group( P < 0. 05). There was no significant difference in gender,hypertension,diabetes,hyperlipidemia,drinking history and HP levels between the two groups( P > 0. 05).Multivariate logistic regression analysis showed that age,smoking history and SAA level are independent risk factors for poor outcome in patients with acute cerebral infarction at 3 months( P < 0. 05). Conclusions SAA level,age and smoking history are independent risk factors for poor outcome of patients with acute cerebral infarction at 3 months,and the level of SAA can be used as a predictor of severity of acute cerebral infarction.
作者
宋明香
蒋敏海
SONG Ming-xiang;JIANG Min-hai(Department of Neurology, The Affiliated Hangzhou Hospital of Nanjing Medical University ( Hangzhou First People,s Hospital ), Hangzhou 310006, China)
出处
《心脑血管病防治》
2019年第3期231-234,共4页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
基金
浙江省杭州市卫生计生科技计划(编号:2018A10)
