脑卒中患者血清CHIL1、AnnexinA1与颈动脉粥样硬化斑块的关系及洛伐他汀干预效果  

Relationship between serum CHIL1,annexin A1 and carotid atherosclerotic plaques in patients with stroke and the interventional effect of lovastatin

作　　者：李永军 杜明 

机构地区：[1]秦皇岛市第四医院检验科,河北秦皇岛066000

出　　处：《海南医学》2017年第4期540-543,共4页Hainan Medical Journal

摘　　要：目的探讨脑卒中患者血清几丁酶样蛋白1(CHIL1)、膜联蛋白A1(Annexin A1)与颈动脉粥样硬化斑块的关系及洛伐他汀干预效果。方法选取2014年6月至2015年6月本院综合内科收治的168例首发脑卒中患者(脑卒中组),另选取160例身体健康体检者为对照组,应用颈动脉彩色多普勒超声检查两组颈动脉内-中膜厚度(IMT),应用全自动化生化分析仪测定两组甘油三脂(TG)、总胆固醇(TC)、低密度蛋白(LDL-C)、高密度蛋白(HDL-C)水平,应用酶联免疫法测定两组血清CHI3L1、Annexin A1水平,胶体金法测定两组C反应蛋白(CRP)。应用Pearson单因素分析脑卒中患者IMT与血脂水平及血清CHIL1、Annexin A1水平的关系。应用Logistic多因素分析脑卒中发生危险因素,对脑卒中患者给予洛伐他汀干预,20 mg/次,1次/d,共干预6个月,观察其干预效果。结果脑卒中组患者的IMT、血清TG、TC、LDL-C、CHIL1及CRP水平均高于对照组,而HDL-C、Annexin A1水平低于对照组,差异均有统计学意义(P<0.05);经Pearson相关性分析显示,IMT与TG、TC、LDL-C、CHIL1、呈正相关(P<0.05),而与Annexin A1 HDL-C呈负相关(P<0.05);经Logistic多因素分析显示,IMT、LDL-C、CHIL1、是脑卒中发生的独立危险因素(P<0.05),而Annexin A1 HDL-C是脑卒中发生的保护因素(P<0.05)。经洛伐他汀干预3个月、6个月后脑卒中患者IMT、血清TG、TC、LDL-C、CHIL1及CRP水平较治疗前显著下降,血清Annexin A1 HDL-C水平较治疗前升高,差异均有统计学意义(P<0.05)。结论 IMT、LDL-C、CHIL1是脑卒中发生的独立危险因素,而HDL-C是脑卒中发生的保护因素。洛伐他汀可通过抑制IMT形成,降低血脂及CHIL1、CRP水平,预防脑卒中复发。Objective To investigate the relationship between serum chitinase like protein 1 （CHILl）, annexin A1 and carotid artery atherosclerotic plaques in patients with stroke and the interventional effect of lovastatin. Methods A total of 168 patients of stroke, who admitted to Department of General Cardiology of our hospital from June 2014 to June 2015, were selected as the stroke group, and 160 healthy volunteers were selected as the control group during the same time. The carotid intima-media thickness （IMT） of the two groups was measured by ultrasound with carotid color Dop- pler. The levels of triglyceride （TG）, total cholesterol （TC）, low-density protein （LDL-C）, and high density protein （HDL-C） of the two groups were identified with fully automated biochemistry analyzer. The levels of CHILl, ANXA1 were measured with enzyme-linked immunosorbent assay （ELISA）. The levels of C-reactive protein （CRP） of the two groups were evaluated with the colloidal gold method. The relationships between IMT and the levels of serum lipid, CHILl, ANXA1 in patients with stroke were analyzed by Pearson single factor. Logistic multivariate analysis was used to analyze the risk factors of stroke. Lovastatin was given to patients with stroke at the dose of 20 mg once a day for 6 months, and the intervention effect was observed. Results The levels of IMT, serum TG, TC, LDL-C, CHI3L1 and CRP of the stroke group were significantly higher than those of the control group （P〈0.05）, while the levels of annexin A1, HDL-C of the stroke group were significantly lower than those of the control group （P〈0.05）. Pearson＇s single factor analysis showed that IMT were positively correlated with TG, TC, LDL-C, CHILl （P〈0.05） and negatively correlated with annexin A1, HDL-C （P〈0.05）. Logistic multivariate analysis showed that IMT, LDL-C, CHILI were the indepen- dent risk factors of stroke, while annexin A1, HDL-C was the protective factors of stroke （P〈0.05）. After three and six months of lova

关 键 词：脑卒中 几丁酶样蛋白1 膜联蛋白A1 颈动脉粥样硬化斑块 洛伐他汀 

分 类 号：R743.3[医药卫生—神经病学与精神病学]