急性脑梗死患者脂联素、高迁移率族蛋白1以及胰岛素抵抗水平与合并心肌梗死的相关性分析  

Correlation analysis between adiponectin and HMGB1 in patients with acute cerebral infarction complicated by myocardial infarction

作　　者：周辉杰 于元英[1] 王晓蕾[1] 刘祖光 冯立华[1] Zhou Huijie;Yu Yuanying;Wang Xiaolei;Liu Zuguang;Feng Lihua(Department of Neurology,Haiyang People's Hospital,Haiyang,Shandong 265100,China)

机构地区：[1]海阳市人民医院神经内科,山东省265100

出　　处：《中国基层医药》2020年第12期1466-1471,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探究急性脑梗死合并心肌梗死患者血清脂联素(APN)、高迁移率族蛋白1(HMGB1)以及胰岛素抵抗水平,并分析其与合并心肌梗死间的相关性。方法收集2016年1月至2019年6月于海阳市人民医院就诊的急性脑梗死患者448例作为研究对象,根据患者是否合并心肌梗死将其分为合并心肌梗死组(36例)和非心肌梗死组(412例),并选择50例同期在该院体检健康者作为健康对照组。收集所有研究对象的空腹静脉血,检测血清APN、HMGB1、凝血指标、炎性指标、心肌梗死标志物以及胰岛素抵抗水平。结果合并心肌梗死组患者的心肌梗死标志物水平[肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTnⅠ)、肌红蛋白(Mb)]、凝血指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、抗凝血酶Ⅲ(AT-Ⅲ)、活化凝血时间(ACT)]、炎性水平[HMGB1、APN、C反应蛋白(CRP)、白细胞介素6(IL-6)]以及胰岛抵抗相关指标[空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗稳定模型评估指数(HOMA-IR)、胰岛素敏感指数(ISI)]与非心肌梗死组差异均有统计学意义[CK-MB:(25.33±4.61)μg/L比(21.85±4.73)μg/L,t=6.028,P<0.001;cTnⅠ:(7.96±0.98)μg/L比(4.89±1.05)μg/L,t=24.135,P<0.001;Mb:(91.07±15.21)g/L比(147.53±16.04)g/L,t=28.981,P<0.001;APTT:(34.02±6.12)s比(37.21±6.31)s,t=4.144,P=0.005;PT:((14.32±1.21)s比(12.94±1.37)s,t=8.390,P<0.001;AT-Ⅲ:(144.62±18.35)s比(167.53±20.04)s,t=9.382,P<0.001;ACT:(135.84±15.21)s比(145.06±16.02)s,t=4.711,P<0.001;HMGB1:(25.61±3.84)μg/mL比(19.27±4.21)μg/mL,t=12.456,P<0.001;APN:(6.03±0.78)mg/L比(9.16±0.97)mg/L,t=26.995,P<0.001;CRP:(46.12±2.87)mg/L比(39.36±3.21)mg/L,t=17.608,P<0.001;IL-6:(8.76±1.42)mg/L比(5.04±1.22)mg/L,t=25.238,P<0.001;FPG:(6.27±0.98)mmol/L比(5.62±1.05)mmol/L,t=5.106,P<0.001;FINS:(24.07±4.25)mIU/L比(15.84±4.46)mIU/L,t=15.235,P<0.001;HOMA-IR:(6.68±0.68)比(3.96±0.84),t=27.217,P<0.001;ISI:(-5.03±0.84)比(-4.57±0.97),t=3.963,P<0.001]。合并心肌Objective To investigate the level of serum adiponectin(APN),high mobility group box 1(HMGB1)and insulin resistance in patients with acute cerebral infarction complicated by myocardial infarction,and try to investigate the correlation between them.Methods From January 2016 to June 2019,448 patients who diagnosed as acute cerebral infarction in Haiyang People's Hospital were selected.The patients were divided into myocardial infarction(MI)group(36 cases)and non-MI group(412 cases)based on whether they complicated with MI.And 50 healthy people were selected as healthy control group.Fasting venous blood was collected from all subjects,and the adiponectin,HMGB1,coagulation indicators,inflammatory indicators,myocardial infarction markers and insulin resistance were measured.Results The markers of myocardial infarction(CK-MB,cTnⅠ,Mb),coagulation indicators(APTT,PT,AT-Ⅲ,ACT),inflammatory levels(HMGB1,APN,CRP,IL-6)and insulin resistance related indicators(FPG,FINS,HOMA-IR,ISI)in patients with MI were different from patients with non-MI[CK-MB:(25.33±4.61)μg/L vs.(21.85±4.73)μg/L,t=6.028,P<0.001;cTnⅠ:(7.96±0.98)μg/L vs.(4.89±1.05)μg/L,t=24.135,P<0.001;Mb:(91.07±15.21)g/L vs.(147.53±16.04)g/L,t=28.981,P<0.001;APTT:(34.02±6.12)s vs.(37.21±6.31)s,t=4.144,P=0.005;PT:(14.32±1.21)s vs.(12.94±1.37)s,t=8.390,P<0.001;AT-Ⅲ:(144.62±18.35)s vs.(167.53±20.04)s,t=9.382,P<0.001;ACT:(135.84±15.21)s vs.(145.06±16.02)s,t=4.711,P<0.001;HMGB1:(25.61±3.84)μg/mL vs.(19.27±4.21)μg/mL,t=12.456,P<0.001;APN:(6.03±0.78)mg/L vs.(9.16±0.97)mg/L,t=26.995,P<0.001;CRP:(46.12±2.87)mg/L vs.(39.36±3.21)mg/L,t=17.608,P<0.001;IL-6:(8.76±1.42)mg/L vs.(5.04±1.22)mg/L,t=25.238,P<0.001;FPG:(6.27±0.98)mmol/L vs.(5.62±1.05)mmol/L,t=5.106,P<0.001;FINS:(24.07±4.25)mIU/L vs.(15.84±4.46)mIU/L,t=15.235,P<0.001;HOMA-IR:(6.68±0.68)vs.(3.96±0.84),t=27.217,P<0.001;ISI:(-5.03±0.84)vs.(-4.57±0.97),t=3.963,P<0.001]and the healthy controls[CK-MB:(25.33±4.61)μg/L vs.(20.04±4.52)μg/L,t=7.280,P<0.001;cTnⅠ:(7.96±0.98)μg/L vs.(4.04

关 键 词：梗塞 大脑中动脉 心肌梗塞 脂联素 胰岛素 高迁移率族蛋白质类 炎症趋化因子类 凝血酶原时间 抗凝血酶Ⅲ 动脉粥样硬化 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R542.22[医药卫生—临床医学]