血浆纤维连接蛋白与急性缺血性卒中患者出血性转化的相关性  

Correlation between plasma fibronectin and hemonhagic transformation in patients with acute ischendc stroke

作　　者：袁文肖[1] 安中平[1] 

机构地区：[1]天津市环湖医院神经内科,300060

出　　处：《国际脑血管病杂志》2012年第3期161-164,共4页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨血浆纤维连接蛋白（fibronectin，Fn）水平与急性缺血性卒中患者出血性转化（hemorrhagictransformation，HT）的关系。方法前瞻性纳入发病72h内、基线MRJ（包括梯度回波序列）未见出血且未行溶栓治疗的急性缺血性卒中患者，在发病7～10d后复查MRI，根据有无出血分为HT组和非HT组，比较两组患者血浆Fn水平。采用logistic回归分析探讨HT的预测因素。结果共纳入78例急性缺血性卒中患者，其中11例（14．10％）发生HT。HT组心房颤动（36．4％对9．0％，P=0．012）和心源性栓塞（36．4％对6．0％，P=0．002）比例显著性高于非HT组，基线平均收缩压[（182．09±20．73）1TimHg（1mmHg=0．133kPa）对（161．25±26．40）toniHg，P=0．015]、平均舒张压[（98．00±11．26）mmHg对（86．60_-4-15．21）rainHg，P=0．020]和血浆Fn浓度[（4835．04±756．30）μg/L对（3849．44±1289．18）μg/L，P=n016]均显著性高于非HT组。多变量logistic回归分析显示，血浆Fn浓度[优势比（oddsratio，OR）1．001，95％可信区间（confidenceinterval，CI）1．000～1．001，P=0．0171和心房颤动（OR13．408，95％CI1．963～91．592；P=0．008）是急性缺血性卒中患耆发生HT的独立预测因素。结论HT患者血浆Fn水平显著增高，血浆Fn水平可作为急性缺血性卒中发病后非溶栓性HT的独立预测因素。Objective To investigate the correlation between plasma fibronectin （Fn） level and the hemor- rhagic transformation （HT） in patients with acute ischemic stroke. Methods Patients with acute ischemic stroke, symptom onset within 72 hours, no bleeding at baseline MRI （including gadient echo sequences） and without thrombolytic therapy were recruited prospectively. At 7 - 10 days after symptom onset reexamined MRI. The patients were divided into HT and non-HT groups according to whether they had a hemorrhage or not. The plasma Fn lew＇,ls in both groups were compared. Logistic regession analysis was used to investigate the predictors of HT. Results A total of 78 patients were included, and among them 11 patients （14. 10% ） showed HT. The proportions of atrial fibrillation （36. 4% vs. 9. 0%, P = 0. 012） and cardioembolism （36. 4% vs. 6. 0%, P =0. 021） in the HT group were significantly higher than those in the non-HT group. The baseline mean systolic blood pressure （182. 09 ±20. 73 mm Hg [1 mm Hg=0. 133 kPa] vs. 161.25 ±26. 40）mm Hg, P =0. 015）, mean diastolic blood pressure （98.00± 11.26 mm Hg vs. 86. 60 ± 15.21 mm Hg, P =0. 020）, and plasma Fn level （4 835. 04 ±756. 30 μg/L vs. 3 849. 44 ± 1 289. 18 μg/L, P = 0. 016） were all significantly higher than those in the non-HT group. Multivariate logistic regression analysis showed that plasma Fn level （odds ratio OR], 1. 001, 95% confidence interval [ CI 1. 000 - 1. 001, P =0. 017） and atrial fibrillation （OR, 13. 408, 95% CI 1. 963 -91. 592, P =0. 008） were the independent predictors of HT in patients with acuteischemic stroke. Conclusions The plasma Fn level in patients with HT increased significantly. The plasma Fn level can be used as an independent predictor of non-thrombolytic HT after the onset of acute ischemic stroke.

关 键 词：纤维连接蛋白 卒中 脑缺血 脑出血 磁共振成像 心房颤动 

分 类 号：R743.3[医药卫生—神经病学与精神病学]