视黄醇结合蛋白4与急性缺血性脑卒中患者脑梗死体积的关系及对病情严重程度的预测价值  

The relationship between RBP4 and infarct volume in patients with acute ischemic stroke and its predictive value for severity

作　　者：侯丹[1] 余丹[1] 杨国帅[1] HOU Dan;YU Dan;YANG Guoshuai(Department of Neurology,Central South University Xiangya School of Medicine Affiliated Haikou Hospital,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院神经内科

出　　处：《实用医学杂志》2019年第24期3818-3822,共5页The Journal of Practical Medicine

基　　金：2011年海南省国际科技合作专项项目(编号：GJXM201107)

摘　　要：目的探讨急性缺血性脑卒中(acute ischemic stroke,AIS)患者视黄醇结合蛋白4(retinolbinding protein 4,RBP4)水平与脑梗死体积的关系以及对病情严重程度的预测价值。方法前瞻性纳入2016年8月至2018年8月收治的130例首发AIS患者和同期100例健康人群作为研究对象。采用Pearson相关分析法分析血清RBP4水平与脑梗死体积的相关性。采用多元线性回归分析影响AIS患者出院6个月后病情严重程度的因素。结果对照组、不明原因脑卒中、大动脉粥样硬化型脑卒中、心源型脑卒中、小动脉闭塞型脑卒中患者RBP4水平分别为[(22.05±6.41)mg/L,n=100]、[(25.56±6.05)mg/L,n=52]、[(27.85±6.38)mg/L,n=30]、[(30.05±6.81)mg/L,n=20]和[(34.44±6.82)mg/L,n=28],RBP4水平逐渐升高,差异有统计学意义(F=18.02,P=0.01)。对照组、轻度脑卒中、中度脑卒中、重度脑卒中患者RBP4水平分别为[(22.05±6.41)mg/L,n=100]、[(26.05±6.15)mg/L,n=40]、[(29.58±6.48)mg/L,n=55]和[(33.19±6.42)mg/L,n=35],RBP4水平逐渐升高,差异有统计学意义(F=15.44,P=0.02)。AIS患者RBP4水平与脑梗死体积呈正相关(r=0.22,P=0.03)。年龄、收缩压、hs-CRP、RBP4为NIHSS评分的独立影响因素(t=2.03、2.85、8.48、4.41,P=0.04、P=0.01、<0.001、<0.001)。结论入院时血清RBP4水平与AIS患者脑梗死体积呈正相关,并能有效预测AIS患者短期病情严重程度。Objective To investigate the relationship between retinol-binding protein 4(RBP4)level and cerebral infarct volume in patients with acute ischemic stroke(AIS)and its predictive value for severity of the disease. Methods 130 first-episode AIS patients and 100 healthy people admitted from August 2016 to August 2018 were prospectively included. Pearson correlation analysis was used to analyze the correlation between serum RBP4 level and infarct volume. Multivariate linear regression analysis was used to analyze the factors affecting the severity of AIS patients 6 months after discharge. Results The levels of RBP4 in control group,unexplained stroke,large atherosclerotic stroke,cardiogenic stroke and small artery occlusive stroke were[(22.05 ± 6.41)mg/L,n = 100],[(25.56 ± 6.05)mg/L,n = 52],[(27.85 ± 6.38)mg/L,n = 30],[(30.05 ± 6.81)mg/L,n = 20]and[(34.44± 6.82)mg/L,n = 28],respectively. The levels of RBP4 gradually increased with significant difference(F =18.02,P = 0.01). The levels of RBP4 in control group,mild stroke,moderate stroke and severe stroke patients were[(22.05 ± 6.41)mg/L,n = 100],[(26.05 ± 6.15)mg/L,n = 40],[(29.58 ± 6.48)mg/L,n = 55]and[(33.19 ± 6.42)mg/L,n = 35],respectively. The levels of RBP4 gradually increased with significant difference(F = 15.44,P = 0.02). The RBP4 levels in AIS patients were positively correlated with infarct volume(r = 0.22,P = 0.03). Age,systolic blood pressure,Hs-CRP and RBP4 were regarded as independent influencing factors of NIHSS score(t = 2.03,2.85,8.48,4.41;P = 0.04,0.01,< 0.001,< 0.001). Conclusons Serum RBP4 level at admission is positively correlated with infarct volume in AIS patients,and can effectively predict the short-term severity of AIS patients.

关 键 词：急性缺血性脑卒中 视黄醇结合蛋白4 脑梗死体积 病情 预测 

分 类 号：R74[医药卫生—神经病学与精神病学]