老年急性脑梗死患者血清OX−LDL、HSP27水平与脑水肿及短期预后关系  

Relationship between serum OX-LDL,HSP27 levels and brain edema and short-term prognosis in elderly patients with acute cerebral infarction

作　　者：李丽媛[1] 殷椿茂 杨帅凯 贺刚锐[1] 王利军[1] LI Liyuan;YIN Chunmao;YANG Shuaikai;HE Gangrui;WANG Lijun(Department of Neurology II,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院神经内二科,河南郑州450052

出　　处：《山东第一医科大学（山东省医学科学院）学报》2023年第2期125-129,共5页Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences

摘　　要：目的分析老年急性脑梗死(acute cerebral infarction,ACI)患者血清氧化低密度脂蛋白(oxidized low density lipoprotein,OX-LDL)、热休克蛋白27(heat shock proteins 27,HSP27)水平与脑水肿严重程度及短期预后的关系。方法回顾性分析2019年1月—2021年9月郑州大学第五附属医院收治的初发老年ACI患者120例(研究组)住院后当天,第3、5、7天的病例资料,按照患者住院当天美国国立卫生院卒中量表(national institute health stroke scale,NIHSS)评分分为轻度组(n=36)、中度组(n=50)、重度组(n=34),于发病后90天,根据改良Rankin量表(modified Rankin Scale,mRS)评分分为预后良好组(n=82)和预后不良组(n=38);另取同期门诊健康体检者120例为对照组。采用酶联免疫吸附试验(ELISA)检测血清OX-LDL、HSP27水平,采用BORN-BE无创脑水肿动态监护仪检测患侧及对照组同侧大脑半球脑电阻抗扰动系数(coefficient of electrical impedance,CEI),采用Pearson法分析血清OX-LDL、HSP27水平与CEI扰动系数的相关性。结果与对照组比较,轻度组、中度组、重度组ACI患者NIHSS评分依次升高,差异有统计学意义(P<0.05)。与对照组比较,轻度组、中度组、重度组ACI患者血清OX-LDL水平、CEI依次增加,差异有统计学意义(P<0.05),均呈先增加后降低趋势,在第5天达到高峰,于第7天开始下降;血清HSP27水平依次降低,差异有统计学意义(P<0.05),随时间变化趋势与OX-LDL相反。Pearson相关性分析结果显示,ACI患者各时间点血清OX-LDL与CEI均呈正相关(P<0.05),血清HSP27水平与CEI均负相关(P<0.05)。与预后良好组比较,预后不良组患者各时间点血清OX-LDL水平升高,差异有统计学意义(P<0.05),随住院时间延长呈先升高后降低趋势,且在第5天达到高峰,第7天开始下降;血清HSP27水平降低,差异有统计学意义(P<0.05),随时间变化趋势与OXLDL相反。结论血清OX-LDL、HSP27水平变化与ACI患者病情、脑水肿严重程度及预后有�Objective:To analyze the relationships between the levels of oxidized low density lipoprotein(OX-LDL),heat shock protein 27(HSP27)and the severity of cerebral edema and short-term prognosis in elderly patients with acute cerebral infarction(ACI).Methods:The pathological data of 120 elderly patients with ACI admitted to our hospital from January 2019 to September 2021 were collected on the 3d,5d and 7d after hospitalization for the retrospective study,and the patients were divided into mild group(n=36),moderate group(n=50)and severe group(n=34)according to the NIHSS score on the day of hospitalization.At 90 days after onset,the patients were divided into good prognosis group(n=82)and poor prognosis group(n=38)according to the modified Rankin Scale(mRS),and another 120 cases of outpatient health examination were taken as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect the levels of OX-LDL and HSP27,brain electrical impedance disturbance coefficient(CEI)of affected side of patients and the same side of the control group was measured by BORN-BE non-invasive brain edema dynamic monitor,and Pearson method was used to analyze the correlations between serum OX-LDL,HSP27 and CEI disturbance coefficient.Results:Compared with the control group,the NIHSS score of ACI patients in mild group,moderate group and severe group increased in turn(P<0.05).Compared with the control group,the serum OX-LDL level and CEI of patients with ACI in mild,moderate and severe groups increased in turn (P < 0. 05), and they all increased first and then decreased, peaked on the 5th day andbegan to decline on the 7th day;the level of serum HSP27 decreased in turn (P < 0. 05), and the trend of change with timewas opposite to that of OX-LDL. Pearson correlation analysis showed that serum OX-LDL was positively correlated with CEIat all time points in ACI patients (P < 0. 05), and serum HSP27 was negatively correlated with CEI (P < 0. 05). Comparedwith the good prognosis group, the serum OX-LDL level in the poor prognosis g

关 键 词：急性脑梗死 氧化低密度脂蛋白 热休克蛋白27 脑水肿 

分 类 号：R743.33[医药卫生—神经病学与精神病学]