同型半胱氨酸糖化血红蛋白神经胶质纤维酸性蛋白在急性缺血性卒患者中的表达及意义  

Expression and Significance of Homocysteine Glycosylated Hemoglobin and Glial Fibrillary Acidic Protein in Patients with Acute Ischemic Stroke

作　　者：张楠[1] 贾永花 冀旗玲 杜会山[1] ZHANG Nan;JIA Yonghua;JI Oiling(Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院神经内科,北京101149

出　　处：《河北医学》2018年第8期1261-1266,共6页Hebei Medicine

基　　金：北京市自然科学基金项目;(编号:2011K057)

摘　　要：目的:探讨同型半胱氨酸(Hcy)、糖化血红蛋白(HbAlc)、神经胶质纤维酸性蛋白(GFAP)在急性缺血性卒中患者中的表达及意义。方法:选择2015年10月至2016年10月我院接诊的急性缺血性卒中患者80例,作为观察组,并选择同期我院接诊的健康体检人群80例,作为对照组。使用酶联免疫吸附法(ELISA)检测所有受试者Hcy、HbAlc、GFAP的表达,并比较不同梗死程度、不同病情严重程度、不同预后急性缺血性卒中患者Hcy、HbAlc、GFAP的表达,分析Hcy、HbAlc、GFAP和急性缺血性卒中的关系。结果:观察组Hcy、HbAlc、GFAP均明显高于对照组(P<0.05);随着患者梗死面积的增加、病情严重程度的增加,Hcy、HbAlc、GFAP的表达也随之增加,比较均具有显著差异(P<0.05);预后不良组患者Hcy、HbAlc、GFAP明显高于预后良好组(P <0.05);经Pearson相关分析显示,Hcy、HbAlc、GFAP和美国国立卫生研究院卒中量表(NIHSS)评分、脑梗死面积之间均呈正相关(P<0.05);且在Logistic回归中显示,Hcy、HbAlc、GFAP均是影响急性缺血性卒中患者预后的危险因素(P<0.05)。结论:Hcy、HbAlc、GFAP均是影响急性缺血性卒中神经功能缺损程度和预后的独立危险因素,可作为诊断、治疗、评估病情的重要指标,临床应用价值高。后不良组患者Hcy、HbAlc、GFAP明显高于预后良好组(P<0.05);经Pearson相关分析显示,Hcy、HbAlc、GFAP和美国国立卫生研究院卒中量表(NIHSS)评分、脑梗死面积之间均呈正相关(P<0.05);且在Logistic回归中显示,Hcy、HbAlc、GFAP均是影响急性缺血性卒中患者预后的危险因素(P<0.05)。结论:Hcy、HbAlc、GFAP均是影响急性缺血性卒中神经功能缺损程度和预后的独立危险因素,可作为诊断、治疗、评估病情的重要指标,临床应用价值高。Objective： To study the expression and significance of homocysteine（Hcy）,glycosylated hemoglobin（HbAlc）,glial fibrillary acidic protein（GFAP） in acute ischemic stroke patients. Methods： 80 patients of acute ischemic stroke received therapy from Oct. 2015 to Oct. 2016 in our hospital were selected as observation group,in the same period,80 healthy people who received medical examination in our hospital were selected as the control group. Enzyme linked immunosorbent assay（ELISA） was used to detect the expression of Hcy,HbAlc and GFAP in all subjects,the expression of Hcy,HbAlc and GFAP in patients with acute ischemic stroke with different infarct level,different severity of disease and different prognosis were compared,and the relationship between Hcy,HbAlc,GFAP and acute ischemic stroke was analyzed. Results：The Hcy,HbAlc and GFAP in the observation group were significantly higher than those in the control group（P0.05）; the expression of Hcy,HbAlc and GFAP increased with the increase of infarct size and the severity of the disease,and the difference was significantly different（P 0.05）; the Hcy,HbAlc and GFAP in the poor prognosis group were significantly higher than those in the good prognosis group（P 0.05）; the Pearson correlation analysis showed that there was a positive correlation between Hcy,HbAlc,GFAP and the degree of National Institutes of Health Stroke Scale（NIHSS） scores and the area of cerebral infarction（P 0.05）; and in Logistic regression,Hcy,HbAlc,and GFAP are all risk factors affecting the prognosis of patients with acute ischemic stroke（P 0.05）. Conclusion： Hcy,HbAlc and GFAP are independent risk factors that affect the degree and prognosis of acute ischemic stroke,it can be used as an important indicator of diagnosis,treatment and evaluation of the disease,and it is of high value in clinical application.

关 键 词：急性缺血性卒中 神经功能 同型半胱氨酸 糖化血红蛋白 神经胶质纤维酸性蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学]