ADAMTS13和vWF在急性和慢性脑血管病患者血浆中的表达及其临床意义  

Level Changes and Clinical Significance of Plasma ADAMTS13 and VWF in Patients with Acute and Chronic Cerebrovascular Disease

作　　者：刘美霞 周龙 朱祖欣 刘群会 LIU Mei-xia;ZHOU Long;ZHU Zu-xin(Department of Neurology,The Central Hospital of Enshi Autonomous Prefecture,Enshi Hubei 445000,China)

机构地区：[1]湖北省恩施土家族苗族自治州中心医院神经内科,湖北恩施445000 [2]湖北省恩施土家族苗族自治州中心医院神经外科,湖北恩施445000

出　　处：《医学临床研究》2020年第1期64-67,共4页Journal of Clinical Research

摘　　要：【目的】探讨Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶(ADAMTS13)和血管性血友病因子(vWF)在急性缺血性脑卒中(AIS)和慢性脑血管病(CCVD组)患者血浆中的表达与其临床意义。【方法】选择2016年4月至2017年4月在本院诊治的86例AIS患者(AIS组)、94例CCVD患者(CCVD)及89例健康体检者(CON组)作为研究对象,采用全自动生化分析仪检测血清中总胆固醇(TC)、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)水平,采用酶联免疫吸附法(ELISA)检测血浆ADAMTS13抗原、vWF抗原水平并计算vWF/ADAMTS13,分析ADAMTS13抗原与vWF抗原和两者与血脂指标的相关性及其在疾病中诊断价值。【结果】AIS组、CCVD组中TC、TG、LDL-C表达水平显著高于CON组,HDL-C水平显著低于CON组(P<0.05),但AIS组、CCVD组上述指标比较差异无统计学意义(P>0.05)。AIS组、CCVD组vWF抗原、VWF/ADAMTS13均显著高于CON组,且AIS组vWF抗原、vWF/ADAMTS13显著高于CCVD组(P<0.05);AIS组、CCVD组ADAMTS13抗原显著低于CON组,且AIS组ADAMTS13抗原显著低于CCVD组(P<0.05)。在AIS组、CCVD组中,vWF抗原与ADAMTS13抗原呈显著负相关(均P<0.05);vWF抗原与TC、TG、LDL-C呈正相关,与HDL-C呈负相关;ADAMTS13抗原与TC、TG、LDL-C呈负相关,与HDL-C呈正相关(P<0.05)。在AIS组与CCVD组中,ROC分析结果显示vWF/ADAMTSl诊断价值均高于vWF抗原、ADAMTS13抗原。【结论】ADAMTS13、vWF参与AIS和CCVD疾病发生发展,且与血脂异常存在密切联系;vWF/ADAMTS13可作为临床AIS和CCVD诊断的有效指标。【Objective】To investigate the level changes and clinical significance of plasma ADAMTS13(a disintegrin-like and metalloprotease with thrombospondin type 1 motif)and vWF(von Willebrand factor)in patients with acute ischemic stroke(AIS)and chronic cerebrovascular disease(CCVD).【Methods】A retrospective analysis of the clinical data of 86 patients with acute ischemic stroke(the AIS group),94 cases of CCVD(the CCVD group)and 89 cases of healthy physical examination volunteers(the CON group)that collected in our hospital from April 2016 to April 2017 were conducted,the levels o￡serum total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)were analyzed by automatic biochemical analyzer;enzyme linked immunosorbent assay(ELISA)was used to detect plasma ADAMTS13 antigen and vWF antigen levels,and vWF:ADAMTS13 ratio was calculated.The correlation between ADAMTS13 antigen and vWF antigen was analyzed;and the diagnostic value in disease were explored.【Results】The levels of TC,TG and LDL-C in the AIS group and the CCVD group were significantly higher than those in the CON group,and HDL-C was significantly lower than that in the CON group(P<0.05).There was no significant difference of above indicators between the AIS group and the CCVD(P>0.05).The vWF antigen and vWF:ADAMTS13 in the AIS group and the CCVD group were significantly higher than those in the CON group;the vWF antigen and vWF:ADAMTS13 in the AIS group were higher than those in the CCVD group(P<0.05).The ADAMTS13 antigen in the AIS group and the CCVD group was significantly lower than that in the CON group;the ADAMTS13 antigen in the AIS group was lower than that in the CCVD group(P<0.05).In the AIS group and the CCVD group,vWF antigen was negatively correlated with ADAMTS13 antigen(P<0.05).Furthermore,vWF antigen was positively correlated with TC,TG and LDL-C but negatively correlated with HDL-C;ADAMTS13 antigen was negatively correlated with TC,TG and LDL-C,but positively correla

关 键 词：脑血管意外 抗血管性血友病因子抗体 抗血管性血友病因子裂解酶 

分 类 号：R743.3[医药卫生—神经病学与精神病学]