血清正五聚蛋白3水平与急性脑梗死患者预后的关系研究  

Relationship between Serum Pentraxin 3 Level and Prognosis in Patients with Acute Cerebral Infarction

作　　者：靳云姗[1] 魏琰[1] 张俊领[1] 崔永健[1] 王晓莉[1] 张维文[1] 王心颖 高倩[1] 卢蕾[1] 李玉妹[1] Yunshan;WEI Yan;ZHANG Junling;CUI Yongjian;WANG Xiaoli;ZHANG Weiwen;WANG Xinying;GAO Qian;LU Lei;LI Yumei(Harrison International Peace Hospital,Hengshui 053000,China)

机构地区：[1]哈励逊国际和平医院

出　　处：《实用心脑肺血管病杂志》2019年第4期29-32,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：2014年度河北省医学科学研究重点课题计划项目(ZD20140306)

摘　　要：背景近年来我国急性脑梗死(ACI)病死率逐年增长,血清正五聚蛋白3(PTX3)水平对ACI患者临床疗效及预后具有一定影响,但关于其与ACI患者预后的关系研究报道较少。目的探讨血清PTX3水平与ACI患者预后的关系。方法选取2015年9月-2018年2月哈励逊国际和平医院收治的ACI患者135例,根据美国国立卫生研究院卒中量表(NIHSS)评分分为预后良好组(0~15分,n=57)和预后不良组(≥16分,n=78)。比较两组患者一般资料,治疗前及治疗第1天、治疗第7天、治疗第14天、治疗后3个月血清PTX3水平,治疗前后血脂指标〔包括三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)〕、改良Ashworth评分、简化Fugl-Meyer运动功能评分。结果(1)预后良好组患者收缩压(SBP)<140 mm Hg、舒张压(DBP)<90 mm Hg者所占比例高于预后不良组(P<0.05);两组患者白细胞计数(WBC)、吸烟时间、饮酒时间及合并慢性疾病者所占比例比较,差异无统计学意义(P>0.05)。(2)时间与方法在血清PTX3水平上存在交互作用,时间、方法在血清PTX3水平上主效应显著(P<0.05);预后良好组患者治疗第7天、治疗第14天、治疗后3个月血清PTX3水平低于预后不良组(P<0.05)。(3)治疗前两组患者TG、LDL-C、HDL-C、TC比较,差异无统计学意义(P>0.05);治疗后预后良好组患者TG、LDL-C、TC低于预后不良组,HDL-C高于预后不良组(P<0.05)。(4)治疗前两组患者改良Ashworth评分、简化Fugl-Meyer运动功能评分比较,差异无统计学意义(P>0.05);治疗后预后良好组患者改良Ashworth评分低于预后不良组,简化Fugl-Meyer运动功能评分高于预后不良组(P<0.05)。结论与预后良好的ACI患者相比,预后不良的ACI患者血清PTX3水平较高,临床可结合血压、血脂指标、肌张力、运动功能等及时调整治疗方案,以改善ACI患者预后。Background Fatality rate of acute cerebral infarction(ACI)increases year by year in China,serum pentraxin 3(PTX3)level has certain impact on clinical effect and prognosis in patients with ACI,but reports about relationship between serum PTX3 level and prognosis in patients with ACI is relatively rare. Objective To investigate the relationship between serum PTX3 level and prognosis in patients with ACI. Methods A total of 135 patients with ACI were selected in Harrison International Peace Hospital from September 2015 to February 2018,and they were divided into goodprognosis group(with NIHSS score between 0 and 15,n=57)and poor-prognosis group(with NIHSS score equal or over 16,n=78)according to NIHSS score. General information,serum PTX3 level before treatment,at the 1 st,7 th and 14 th day of treatment,3 months after treatment,blood lipid index(including TG,LDL-C,HDL-C and TC),modified Ashworth score and simplified Fugl-Meyer assessment score before and after treatment were compared between the two groups. Results(1)Proportions of patients with SBP less than 140 mm Hg and DBP less than 90 mm Hg in good-prognosis group were statistically significantly higher than those in poor-prognosis group(P<0.05);while no statistically significant difference of WBC,smoking history,drinking history or proportion of patients merged with chronic disease was found between the two groups(P>0.05).(2)There was statistically significant difference of interaction in serum PTX3 level between time and method,meanwhile main effects of time and method were statistically significant in serum PTX3 level(P<0.05);serum PTX3 level in goodprognosis group was statistically significantly lower than that in poor-prognosis group at the 7 th and 14 th day of treatment,and3 months after treatment,respectively(P<0.05).(3)No statistically significant difference of TG,LDL-C,HDL-C or TC was found between the two groups before treatment(P>0.05);after treatment,TG,LDL-C and TC in good-prognosis group were statistically significantly lower than those in poor-

关 键 词：脑梗死 正五聚蛋白3 预后 肌张力 运动功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]