脂肪因子与老年急性缺血性脑卒中血管内介入治疗短期预后的关系  

Relationship between adipokines and short-term outcome in elderly acute ischemic stroke patients after intravascular intervention

作　　者：王颍超 王晨雨[2] 刘磊[1] 臧文举[1] 王琨[1] Wang Yingchao;Wang Chenyu;Liu Lei;Zang Wenju;Wang Kun(Department of Invasive Technology,Zhengzhou People's Hospital,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州人民医院介入科,450000 [2]郑州大学第二附属医院超声科

出　　处：《中华老年心脑血管病杂志》2020年第3期296-299,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨脂肪因子在老年急性缺血性脑卒中(AIS)血管内介入治疗短期预后中的价值。方法选择AIS患者86例(AIS组),AIS组又根据入院时美国国立卫生研究院卒中量表(NIHSS)评分分为轻度组20例、中度组54例和重度组12例,术后24 h NIHSS评分分为好转组47例和未好转组39例,术后3个月改良Rankin量表评分分为预后良好组62例和预后不良组24例。收集同期我院健康体检者50例(对照组)。比较各组血清脂肪因子(内脂素、趋化素、抵抗素及网膜素1)水平;并采用logistic回归分析短期预后的影响因素。结果AIS组血清内脂素、趋化素及抵抗素水平明显高于对照组,网膜素1水平明显低于对照组(P<0.01)。重度组血清内脂素、趋化素、抵抗素水平明显高于轻度组,中度组和重度组网膜素1水平明显低于轻度组(P<0.05)。预后不良组内脂素、趋化素及入院时NIHSS评分明显高于预后良好组(P<0.05,P<0.01),网膜素1和早期神经功能好转比例明显低于预后良好组[(170.09±21.09)g/Lvs(158.97±17.13)g/L,P=0.024;61.3%vs 37.5%,P=0.047]。logistic回归分析显示,高血压、糖尿病、内脂素、趋化素、入院时NIHSS评分及早期神经功能好转是AIS患者短期预后的独立影响因素(P<0.05,P<0.01)。结论血清内脂素、趋化素、抵抗素和网膜素1水平与AIS的发病、病情严重程度密切相关,同时内脂素和趋化素水平是老年AIS患者短期预后不良的预测因素。Objective To study the relationship between adipokines and short-term outcome in elderly acute ischemic stroke(AIS)patients after intravascular intervention.Methods Eighty-six elderly AIS patients served as an AIS group and 50 persons undergoing physical examination in our hospital during the same period served as a control group.The patients in AIS group were further divided into mild AIS group(n=20),moderate AIS group(n=54),severe AIS group(n=12)according to their NIHSS score on admission or improved group(n=47)and unimproved group(n=39)according to their NIHSS score at 24 h after operation or good outcome group(n=62)and poor outcome group(n=24)according to their mRS score.The serum levels of adipokines(visfatin,chemerin,resistin and omentin-1)in different groups were measured and compared.The influencing factors of short-term outcome in different groups were analyzed by logistic regression analysis.Results The serum levels of visfatin,chemerin and resistin were significantly higher while those of omentin-1 were significantly lower in AIS group than in control group(P<0.01).The serum levels of visfatin,chemerin and resistin were significantly higher in severe AIS group than in mild AIS group while those of omentum 1 were significantly lower in moderate AIS group and severe AIS group than in mild AIS group(P<0.05).The serum levels of visfatin and chemokine and NIHSS score on admission were significantly higher in poor outcome group than in good outcome group(P<0.05,P<0.01)while the serum level of omentum 1 and the rate of early neurological function improvement were significantly lower in poor outcome group than in good outcome group(170.09±21.09 g/L vs 158.97±17.13 g/L,P=0.024;61.3%vs 37.5%,P=0.047).Logistic regression analysis showed that hypertension,diabetes mellitus,visfatin,chemokine,NIHSS score on admission and early neurological function improvement were the independent influencing factors of short-term outcome in elderly AIS patients(P<0.05,P<0.01).Conclusion Serum levels of visfatin,chemerin,resistin

关 键 词：脂肪因子类 卒中 趋化因子类 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]