脑梗死患者Hcy、BDNF、APO-A/APO-B比值变化及其与神经功能缺损程度的关系  

Expression levels of Hcy,BDNF and APO-A/APO-B ratio,and their relationship with the severity of neurological impairment in patients with cerebral infarction

作　　者：郭晓玉 谷伟[1] 王彦伟 贾海莉 董霞 GUO Xiaoyu;GU Wei;WANG Yanwei;JIA Haili;DONG Xia(Department of General Medicine,First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院全科医学科,河北张家口075000

出　　处：《检验医学与临床》2025年第7期889-893,共5页Laboratory Medicine and Clinic

基　　金：河北省卫生健康委员会课题(20231460)。

摘　　要：目的分析脑梗死患者血清同型半胱氨酸(Hcy)、脑源性神经营养因子(BDNF)、载脂蛋白(APO)-A/APO-B比值及其与神经功能缺损程度的关系。方法选取2020年3月至2022年3月在该院确诊为脑梗死的患者104例作为病例组,另选取同期在该院体检者52例作为对照组。依据美国国立卫生院卒中量表(NIHSS)评分将病例组患者分为轻度神经功能缺损(轻度组,评分1~<14分)、中度神经功能缺损(中度组,评分5~<15分)、重度神经功能缺损(重度组,评分16~42分)。检测所有患者血清Hcy、BDNF、APO-A、APO-B水平,并计算APO-A/APO-B比值。比较病例组与对照组,以及不同神经功能缺损程度脑梗死患者血清Hcy、BDNF水平及APO-A/APO-B比值。采用Pearson相关分析脑梗死患者血清Hcy、BDNF、APO-A/APO-B比值之间的相关性;采用Spearman相关分析脑梗死患者血清Hcy、BDNF、APO-A/APO-B比值与神经功能缺损之间的相关性;采用受试者工作特征(ROC)曲线分析血清Hcy、BDNF水平及APO-A/APO-B比值对脑梗死患者中重度神经功能缺损的评估价值。结果病例组血清Hcy水平高于对照组,血清BDNF水平及APO-A/APO-B比值低于对照组,差异均有统计学意义(P<0.05)。血清Hcy水平比较:轻度组<中度组<重度组,两两比较,差异均有统计学意义(P<0.05);病例组BDNF水平、APO-A/APO-B比值比较:轻度组>中度组>重度组,两两比较,差异均有统计学意义(P<0.05)。血清Hcy水平与血清BDNF水平、APO-A/APO-B比值均呈负相关(r=-5.293、-6.257,P<0.05),血清BDNF水平与APO-A/APO-B比值呈正相关(r=5.384,P<0.05);血清Hcy水平与神经功能缺损程度呈正相关(r=5.179,P<0.05),血清BDNF水平、APO-A/APO-B比值与神经功能缺损程度呈负相关(r=-6.042、-6.133,P<0.05)。ROC曲线分析结果显示,血清Hcy、BDNF水平及APO-A/APO-B比值评估中重度神经功能缺损的AUC分别为0.815、0.781、0.770。结论脑梗死患者血清Hcy水平升高,血清BDNF水平和APO-A/APO-B比�Objective To analyze the changes in serum homocysteine(Hcy),brain-derived neurotrophic factor(BDNF),apolipoprotein(APO)-A/APO-B ratio and their relationship with the degree of neurological dysfunction in patients with cerebral infarction.Methods A total of 104 patients diagnosed with cerebral infarction in the hospital from March 2020 to March 2022 were selected as the case group,and 52 patients who underwent physical examinations in the hospital during the same period were selected as the control group.According to the National Institutes of Health Stroke Scale(NIHSS)score,patients in the case group were divided into mild neurological deficit(mild group,score 1-14),moderate neurological deficit(moderate group,score 5-15),and severe neurological deficit(severe group,score 16-42).The levels of serum Hcy,BDNF,APO-A and APO-B in all patients were detected,and calculate the APO-A/APO-B ratio.The levels of serum Hcy,BDNF and APO-A/APO-B ratio between the case group and the control group,in stroke patients with different degrees of neurological deficits were compared.Pearson correlation analysis was used to investigate the correlation among serum Hcy,BDNF and APO-A/APO-B ratio in stroke patients.Spearman correlation analysis was used to investigate the correlation between serum Hcy,BDNF,APO-A/APO-B ratio and neurological deficits in patients with cerebral infarction.The evaluation value of serum Hcy,BDNF levels and APO-A/APO-B ratio for moderate to severe neurological deficits in patients with cerebral infarction was analyzed using receiver operating characteristic(ROC)curve analysis.Results The results showed that the serum Hcy level in the case group was higher than that in the control group,while the serum BDNF level and APO-A/APO-B ratio were lower than those in the control group,and the differences were statistically significant(P<0.05).Comparison of serum Hcy levels:mild group<moderate group<severe group,pairwise comparison showed statistically significant differences(P<0.05).Comparison of BDNF levels and APO-A/A

关 键 词：脑梗死 同型半胱氨酸 脑源性神经营养因子 载脂蛋白 神经功能 

分 类 号：R446.1[医药卫生—诊断学] R743.3[医药卫生—临床医学]