血清Chemerin及神经生长相关蛋白-43水平与急性缺血性脑卒中合并高同型半胱氨酸血症的相关性  

Relationship between serum Chemerin and nerve growth-associated protein-43 levels and hyperhomocysteinemia in acute ischemic stroke

作　　者：张恒 马亚如 王慧[2] 王佩 杨燕[1] 田润 雷华斌 Zhang Heng;Ma Yaru;Wang Hui;Wang Pei;Yang Yan;Tian Run;Lei Huabin(Clinical Laboratory,Sun Simiao Hospital,Beijing University of Traditional Chinese Medicine,Tongchuang 727031,China;Department of Brain Disease,Sun Simiao Hospital,Beijing University of Traditional Chinese Medicine,Tongchuang 727031,China)

机构地区：[1]北京中医药大学孙思邈医院检验科,铜川727031 [2]北京中医药大学孙思邈医院脑病科,铜川727031

出　　处：《中国医师杂志》2024年第12期1812-1817,共6页Journal of Chinese Physician

基　　金：陕西省中医药管理局课题(SZY-NLTL-2022-042)。

摘　　要：目的探讨血清Chemerin及神经生长相关蛋白(GAP)-43水平与急性缺血性脑卒中合并高同型半胱氨酸血症(HHcy)的相关性。方法回顾性分析2021年3月至2023年5月北京中医药大学孙思邈医院收治的149例急性缺血性脑卒中患者的临床资料,根据患者是否合并HHcy分为观察组(97例)和对照组(52例)。观察组患者根据病情严重程度分为轻度组(n=29)、中度组(n=38)、重度组(n=30)。比较观察组与对照组血清Chemerin、GAP-43水平,比较不同病情严重程度观察组患者血清Chemerin、GAP-43水平,分析血清Chemerin、GAP-43水平与急性缺血性脑卒中合并HHcy患者病情严重程度的相关性,分析急性缺血性脑卒中合并HHcy患者预后不良的影响因素,绘制受试者工作特征(ROC)曲线分析血清Chemerin、GAP-43对急性缺血性脑卒中合并HHcy患者预后不良的预测价值。结果观察组血清Chemerin、GAP-43水平高于对照组(均P<0.05)。重度组血清Chemerin、GAP-43水平高于轻度组、中度组(均P<0.05),中度组血清Chemerin、GAP-43水平高于轻度组(均P<0.05)。Pearson相关性分析结果显示,血清Chemerin、GAP-43水平与急性缺血性脑卒中合并HHcy患者病情严重程度呈正相关(r=0.458,0.497,均P<0.05)。97例急性缺血性脑卒中合并HHcy患者中,预后不良19例,预后良好78例。预后不良组糖尿病、病情严重程度为重度占比及血糖、C反应蛋白(CRP)、血管内皮生长因子(VEGF)、丙二醛(MDA)水平高于预后良好组(均P<0.05),超氧化物歧化酶(SOD)低于预后良好组(P<0.05)。Logistic回归分析结果显示,病情严重程度、CRP、Chemerin、GAP-43为急性缺血性脑卒中合并HHcy患者预后不良的影响因素(均P<0.05)。ROC曲线结果显示,血清Chemerin、GAP-43水平及二者联合预测急性缺血性脑卒中合并HHcy患者预后不良的曲线下面积(AUC)分别为0.799、0.804、0.907,且二者联合的AUC更大(P<0.05)。结论血清Chemerin、GAP-43水平与急性缺�ObjectiveTo investigate the correlation between serum Chemerin and nerve growth associated protein(GAP)-43 levels and hyperhomocysteinemia(HHcy)in acute ischemic stroke.MethodsThe clinical data of 149 patients with acute ischemic stroke admitted to the Sun Simiao Hospital of Beijing University of Traditional Chinese Medicine from March 2021 to May 2023 were retrospectively analyzed,and the patients were divided into observation group(97 cases)and control group(52 cases)according to whether they were combined with HHcy.Observation group patients were divided into mild group(n=29),moderate group(n=38)and severe group(n=30)according to the severity of the disease.The serum Chemerin and GAP-43 levels of the observation group and the control group were compared,and the serum Chemerin and GAP-43 levels of the observation group with different severity of disease were compared,and the correlation between the serum Chemerin and GAP-43 levels and the severity of acute ischemic stroke patients with HHcy was analyzed.The influencing factors of poor prognosis in patients with acute ischemic stroke complicated with HHcy were analyzed,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum Chemerin and GAP-43 for poor prognosis in patients with acute ischemic stroke complicated with HHcy.ResultsThe levels of Chemerin and GAP-43 in the observation group were higher than those in the control group(all P<0.05).Serum Chemerin and GAP-43 levels in the severe group were higher than those in the mild group and the moderate group(all P<0.05),and serum Chemerin and GAP-43 levels in the moderate group were higher than those in the mild group(all P<0.05).Pearson correlation analysis showed that serum Chemerin and GAP-3 levels were positively correlated with the severity of acute ischemic stroke patients with HHcy(r=0.458,0.497,all P<0.05).Among 97 patients with acute ischemic stroke complicated with HHcy,19 had poor prognosis and 78 had good prognosis.In the poor prognosis group,the proportion of

关 键 词：缺血性卒中 高同型半胱氨酸血症 CHEMERIN GAP-43蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R589[医药卫生—临床医学]