摘要
目的:观察发生出血转化(HT)的急性脑梗死(ACI)患者血清脂肪因子Apelin、Vaspin、Leptin的水平,并探讨上述指标对ACI患者发生HT的预测价值。方法:选择于本院确诊并治疗的ACI患者377例作为ACI组,入院24 h内经头颅MRI诊断是否发生HT,ACI组被进一步分为HT组(41例)和非HT组(336例);另选择同期于本院体检的健康者400例作为健康对照组。测量比较上述各组的血清Apelin、Vaspin、Leptin水平;二元Logistic回归分析ACI患者发生HT的影响因素;ROC曲线分析血清Apelin、Vaspin、Leptin水平对ACI患者发生HT的预测价值。结果:与健康对照组比较,ACI组血清Apelin、Vaspin水平显著降低,Leptin水平[(12.62±3.79)ng/ml比(34.59±11.02)ng/ml]显著升高,P均=0.001。与非HT组比较,HT组高血压(30.65%比51.22%)、高血脂比例(19.64%比36.59%)、血清Leptin水平[(33.04±7.32)ng/ml比(40.45±10.78)ng/ml]均显著升高,血清Apelin[(1.76±0.54)ng/ml比(1.21±0.29)ng/ml]和Vaspin[(0.69±0.22)ng/ml比(0.41±0.13)ng/ml]水平均显著降低,P<0.05或<0.01。二元Logistic回归分析显示血清Apelin、Vaspin水平是影响ACI患者发生HT的独立保护因素(OR=0.237,0.255,P=0.007,0.001),而Leptin水平是其独立危险因素(OR=1.060,P=0.001)。Apelin、Vaspin和Leptin预测HT的曲线下面积分别为0.706、0.752和0.677。结论:Apelin、Vaspin在发生HT的ACI患者血清中显著降低,Leptin显著升高,对预测HT有一定价值。
Objective:To observe serum levels of adipocyte factor of Apelin,Vaspin and Leptin in patients with acute cerebral infarction(ACI)suffering hemorrhagic transformation(HT),and explore predictive value of above indexes for HT in ACI patients.Methods:A total of 377 ACI patients who were diagnosed and treated in our hospital were selected as ACI group.According to presence of HT within 24h after hospitalization diagnosed by transcranial MRI,ACI group was further divided into HT group(n=41)and non-HT group(n=336);another 400 healthy subjects undergoing physical examination in our hospital simultaneously were selected as healthy control group.Serum levels of Apelin,Vaspin and Leptin were measured and compared among above groups;binary Logistic regression was used to analyze influencing factors for HT in ACI patients;ROC curve was used to analyze predictive value of serum levels of Apelin,Vaspin and Leptin for HT in ACI patients.Results:Compared with healthy control group,there were significant reductions in serum levels of Apelin,Vaspin,and significant rise in Leptin level in ACI group,P=0.001 all.Compared with non-HT group,there were significant rise in percentages of hypertension(30.65%vs.51.22%),hyperlipidemia(19.64%vs.36.59%),serum Leptin level[(33.04±7.32)ng/ml vs.(40.45±10.78)ng/ml],and significant reductions in serum levels of Apelin[(1.76±0.54)ng/ml vs.(1.21±0.29)ng/ml]and Vaspin[(0.69±0.22)ng/ml vs.(0.41±0.13)ng/ml]in HT group,P<0.05 or<0.01.Binary Logistic regression analysis indicated that serum levels of Apelin and Vaspin were independent protective factors for HT in ACI patients(OR=0.237,0.255,P=0.007,0.001),while Leptin level was its independent risk factor(r=1.060,P=0.001).AUC of Apelin,Vaspin and Leptin was 0.706,0.752 and 0.677 respectively in predicting HT.Conclusion:Serum levels of Apelin and Vaspin significantly reduce,while Leptin significantly rises in ACI patients suffering HT,which possesses certain predictive value for HT.
作者
郭才华
王启章
胡乔
刘勇
李玉浩
杨穗江
吴迪
GUO Cai-hua;WANG Qi-zhang;HU Qiao;LIU Yong;LI Yu-hao;YANG Sui-jiang;WU Di(Department of Cerebrovascular Disease,Integrated Traditional Chinese and Western Medicine Hospital of Shenzhen City,Shenzhen,Guangdong,518104,China)
出处
《心血管康复医学杂志》
CAS
2021年第3期269-273,共5页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
脑梗死
脂肪因子类
瘦素
Brain infarction
Adipokines
Leptin
