高龄卒中患者血清补体C1q、C3及C4水平动态变化对心血管事件预后评估作用及影响因素分析  

Dynamic changes of serum complement C1q,C3,and C4 levels in elder age stroke patients to assess the prognosis of cardiovascular events

作　　者：许丹[1] 果基牛牛 汪亚丽[1] XYU Dan;GUO Ji-niuniu;WANG Ya-li(Laboratory of Deyang People′s Hospital,Deyang,Sichuan 618000,China)

机构地区：[1]四川省德阳市人民医院检验科,四川德阳618000

出　　处：《公共卫生与预防医学》2022年第1期141-145,共5页Journal of Public Health and Preventive Medicine

摘　　要：目的评价85岁以上卒中患者血清补体C1q、C3及C4水平动态变化特征,并分析这些指标对心血管事件预后的评估作用,并探讨其影响因素。方法选取2017年4月至2020年10月德阳市人民医院收治的脑卒中(AIS)患者320例。随后依据心血管事件预后(出现心血管事件并致死,出现心血管事件但不致死,未出现心血管事件)分为3组,同时选取该院门诊患者的血清作为对照。于治疗时,治疗后3 d,治疗后7 d评估血清补体C1q、C3及C4水平。血清补体C1q、C3及C4水平动态变化采用酶联免疫吸附法进行测定。结果患者治疗时,治疗后3 d,治疗后7 d补体C1q、C3及C4水平均呈现逐渐下降的趋势。出现心血管事件并致死,出现心血管事件但不致死,未出现心血管事件的3组患者中,血清补体C1q、C3及C4水平与正常群体相比均显著升高。出现心血管事件并致死组补体C1q、C3及C4水平显著高于出现心血管事件但不致死组,出现心血管事件但不致死组补体C1q、C3及C4水平显著高于未出现心血管事件组,两两组间差异均有统计学意义(P<0.05)。logistic回归分析结果显示,治疗后两个时间节点的补体C1q、C3及C4水平均可作为心血管事件预后的独立影响因素(水平增高是危险因素)。同时,补体水平变化趋势减低是不良心血管事件预后的保护因素。结论85岁以上卒中患者血清补体C1q、C3及C4水平升高提示心血管事件预后不良。动态监测血清补体C1q、C3及C4水平对改善患者预后具有重要意义。Objective To evaluate the dynamic characteristics of serum complement C1q,C3 and C4 levels in stroke patients over 85 years of age,and to analyze the effects of these indicators on the prognosis of cardiovascular events,and to explore its influencing factors.Methods A total of 320 stroke(AIS)patients admitted to our hospital from April 2017 to October 2020 were selected.Then,according to the prognosis of cardiovascular events(cardiovascular events and death,cardiovascular events but not fatal,no cardiovascular events),they were divided into 3 groups.At the same time,the serum of outpatients in the hospital was selected as a control.During treatment,3 days after treatment,and 7 days after treatment,serum complement C1q,C3 and C4 levels were evaluated.The dynamic changes of serum complement C1q,C3 and C4 levels were determined by enzyme-linked immunosorbent assay.Results During the treatment,the levels of complement C1q,C3 and C4 showed a gradual decrease in 3 days after treatment and 7 days after treatment.Cardiovascular events occurred and died,and cardiovascular events occurred but not fatal.In the three groups of patients without cardiovascular events,serum complement C1q,C3 and C4 levels were significantly higher than those of the normal population.The levels of complement C1q,C3 and C4 in the cardiovascular event and fatal group were significantly higher than those in the cardiovascular event but not fatal group,and the complement C1q,C3 and C4 levels in the cardiovascular event but not fatal group were significantly higher than those in the non-cardiovascular event group,The differences between the two groups were statistically significant(P<0.05).Logistic regression analysis showed that the levels of complement C1q,C3 and C4 at the two time points after treatment can be used as independent factors influencing the prognosis of cardiovascular events(increased levels are risk factors).At the same time,the decreasing trend of complement level is a protective factor for the prognosis of adverse cardiovascular ev

关 键 词：卒中 补体 心血管事件 预后 

分 类 号：R181[医药卫生—流行病学]