三种抗体与急性脑梗死患者病情严重程度及预后的关系研究  

Relationship between serum three antibodies and the severity and prognosis of patients with acute cerebral infarction

作　　者：孟会红 刘永刚[1] 邢晓明[1] 张超 赵静[1] 孙庆娜 任翠剑 郭亚平[2] 钱倩 Meng Huihong;Liu Yonggang;Xing Xiaoming;Zhang Chao;Zhao Jing;Sun Qingna;Ren Cuijian;Guo Yaping;Qian Qian(First Department of Neurology,Baoding First Central Hospital of Hebei Province,Hebei Baoding 071000,China;Laboratory,Baoding First Central Hospital of Hebei Province,Hebei Baoding 071000,China;Fifth Department of Neurology,Baoding First Central Hospital of Hebei Province,Hebei Baoding 071000,China)

机构地区：[1]河北省保定市第一中心医院神经内一科,河北保定071000 [2]河北省保定市第一中心医院检验科,河北保定071000 [3]河北省保定市第一中心医院神经内五科,河北保定071000

出　　处：《中国医刊》2022年第12期1314-1317,共4页Chinese Journal of Medicine

基　　金：河北省医学科学研究课题计划项目(20220288);河北省保定市科技计划项目(2041ZF099)。

摘　　要：目的探讨血清抗核抗体(antinuclear antibody,ANA)、抗中性粒细胞胞浆抗体(antineutrophil cytoplasmic antibody,ANCA)、抗心磷脂抗体(anticardiolipin antibody,ACA)与急性脑梗死患者病情严重程度及预后的关系。方法回顾性分析2020年1月至2021年9月河北省保定市第一中心医院收治的206例急性脑梗死患者的临床资料,检测ANA、ANCA、ACA阳性表达情况,根据抗体检测结果进行分组,剔除2例混合阳性病例,将仅ANA阳性的患者纳入ANA阳性组(43例),仅ANCA阳性的患者纳入例ANCA阳性组(29例),仅ACA阳性的患者纳入ACA阳性组(49例),ANA、ANCA和ACA均阴性的患者纳入阴性组(83例)。比较分析各抗体阳性组与阴性组患者的同型半胱氨酸(homocysteine,Hcy)水平、美国国立卫生院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、预后及颅内外动脉狭窄情况。结果ANA、ANCA、ACA阳性组患者的Hcy水平、高同型半胱氨酸血症比例、NIHSS评分、预后不良比例、≥2支动脉狭窄率、中度及以上狭窄率均显著高于阴性组(P<0.05)。结论血清ANA、ANCA、ACA阳性的急性脑梗死患者更易发生高同型半胱氨酸血症和多支动脉狭窄,且动脉狭窄程度更为严重,预后往往较差。Objective To investigate the relationship between serum antinuclear antibody(ANA),antineutrophil cytoplasmic antibody(ANCA),anticardiolipin antibody(ACA)and the severity and prognosis of patients with acute cerebral infarction(ACI).Method The clinical data of 206 patients with ACI admitted to Baoding First Central Hospital of Hebei Province from January 2020 to September 2021were retrospectively analyzed.According to the results of antibody detection,two mixed positive cases were excluded,and only ANA positive patients were included in ANA positive group(43 cases),only ANCA positive patients were included in ANCA positive group(29cases),and only ACA positive patients were included in ACA positive group(49 cases).Patients with negative ANA,ANCA and ACA were included in the negative group(83 cases).The levels of homocysteine(Hcy),NIHSS score,prognosis,intracranial and extracranial artery stenosis were compared and analyzed between the antibody positive and negative groups.Result The levels of Hcy,the proportion of high Hcy,NIHSS score,the proportion of poor prognosis,the rate of≥2 artery stenosis,the rate of moderate and above stenosis in ANA,ANCA and ACA positive groups were significantly higher than those in negative group(P<0.05).Conclusion ACI patients with positive serum ANA,ANCA and ACA are more likely to have hyperhomocysteinemia and multi-vessel artery stenosis,with serious degree of arterial stenosis and poor prognosis.

关 键 词：急性脑梗死 抗核抗体 抗中性粒细胞胞浆抗体 抗心磷脂抗体 同型半胱氨酸 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]