血管性血友病因子瑞斯托霉素辅因子活性与脑梗死的相关性研究  

Correlation between von Willebrand factor ristocetin cofactor activity level and prognosis in cerebral infarction

作　　者：闫彬[1] 陆士奇[2] 翟菊萍[3] 阮长耿[1] 赵益明[1] 

机构地区：[1]苏州大学附属第一医院江苏省血液研究所卫生部血栓与止血重点实验室,江苏苏州215006 [2]苏州大学附属第一医院急诊科 [3]苏州大学附属第一医院血库

出　　处：《中国急救医学》2017年第5期419-423,共5页Chinese Journal of Critical Care Medicine

摘　　要：[摘要]目的探讨血管性血友病因子瑞斯托霉素辅因子活性（Von Willebrand factor ristocetin cofactor activity, VWF ： Rco）在评估脑梗死（cerebral infarction，CI）患者病情及预后两年恢复情况中的临床价值。方法收集2014—07～2015—02我院收治的61例脑梗死患者及104例正常人血浆分别作为病例组和对照组，检测其VWF：Rco水平，根据改良Barthel指数评分和改良Rankin评分细则随访患者预后两年的日常生活活动能力和神经功能恢复情况，并对其资料进行分组和统计学分析。结果病例组VWF：Rco水平显著高于对照组（P〈0．0001），并与VWF抗原呈正相关（r=0．996，P〈0．0001）；患者不同年龄段VWF：Rco水平有差异，并随年龄增长而升高；病例组的血浆超长VWF水平增多；患者初诊VWF：Rco水平与超敏C-反应蛋白（hs—CRP）呈正相关（r=0．382，P=0．002），与预后两年的日常生活活动能力呈负相关（r=0．293，P=0．022），与神经功能恢复情况呈正相关（r=0．269，P=0．036），入院VWF：Rco水平越高，预后恢复越差。结论初诊脑梗死患者显著升高的VWF：Rco水平与病情严重程度相关。VWF：Rco可作为评估脑梗死预后的标志物，初诊VWF：Rco水平越高，患者预后越差。Objective To investigate the clinical value of von Willebrand factor ristocetin cofactor activity （ VWF ： Rco） in assessing the prognosis and 2 - years＇ prognosis of cerebral infarction. Methods 61 patients with cerebral infarction （CIP） and 104 normal controls （CTL） were enrolled from July 2014 to February 2015 in our hospital, respectively. VWF： Rco was measured, then the modified Barthel index and Rankin scoring were used for evaluating the followed up 2 - years＇ prognosis of activities of daily life and neurological recovery. Results CIP had higher VWF： Rco than those in CTL （59.15% vs. 224.0% ,P 〈0.0001 ）, and VWF：Rco was positively correlated with VWF antigen （r =0. 996, P 〈 0.0001 ）; VWF： Rco in CIP with different age group had significant differences and increased with age; ultra -large VWF level in CIP was also increased. VWF： Rco was positively correlated with high - sensitivity C - reactive protein and the recovery of neurological function in the firstly diagnosed CIP （ r = 0. 382, P = 0. 002 ; r = 0. 269, P = 0. 036, respectively）, while negatively correlated with activities of daily life （r = -0. 293, P = 0. 022）. Besides, the higher VWF：Rco, the poorer prognosis. Conclusion CIP had significantly higher VWF ： Rco than those in CTL, and VWF ： Rco is associated with the severity of cerebral infarction. VWF：Rco can be used as a marker for value the prognosis of cerebral infarction. The higher VWF： Rco level, the poorer prognosis.

关 键 词：脑梗死(CI) 血管性血友病因子瑞斯托霉素辅因子活性(VWF:Rco) 超敏C-反应蛋白(hs—CRP) 不良预后 

分 类 号：R541.4[医药卫生—心血管疾病]