急性脑梗死患者不同时期Apelin-13及应激相关蛋白水平的变化及其与预后的关系研究

发布时间：2018-10-20 11:45

【摘要】：目的探讨急性脑梗死(ACI)患者不同时期Apelin-13和应激相关蛋白热休克蛋白70(HSP-70)、β内啡肽(β-EP)水平的变化及其与预后的相关性。方法选取2013年1月—2014年12月在复旦大学附属上海市第五人民医院确诊为ACI的患者50例作为ACI组,另选取同期在本院体检正常者40例作为对照组。采集两组受试者血液,并检测对照组和ACI组发病第1、3、7、14、21、30天Apelin-13、HSP-70、β-EP水平。ACI患者根据改良Rankin分级法评估预后,分为预后好(n=28)、一般(n=15)、差(n=7),并比较不同预后患者发病第1天的Apelin-13、HSP-70、β-EP水平、格拉斯哥昏迷量表(GCS)评分、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、美国国立卫生研究所卒中量表(NHISS)评分、洼田饮水试验分级。结果对照组、ACI组不同时期Apelin-13、HSP-70水平比较,差异有统计学意义(P0.05),β-EP水平比较差异无统计学意义(P0.05);其中ACI组第1天Apelin-13水平低于对照组,ACI组第14、21、30天Apelin-13水平高于ACI组第1天(P0.05);ACI组第1、3天HSP-70水平高于对照组,ACI组第3、7、14、21、30天HSP-70水平低于ACI组第1天(P0.05)。ACI患者Apelin-13与HSP-70呈直线负相关(r=-0.909,P=0.012),Apelin-13与β-EP无直线相关性(r=-0.172,P=0.744),HSP-70与β-EP无直线相关性(r=0.121,P=0.820)。不同预后ACI患者β-EP水平比较,差异无统计学意义(P0.05);不同预后ACI患者Apelin-13、HSP-70水平、GCS评分、APACHEⅡ评分、NHISS评分、洼田饮水试验分级比较,差异均有统计学意义(P0.05);其中预后差者Apelin-13水平、GCS评分均低于预后好和预后一般者,HSP-70水平、APACHEⅡ评分、NHISS评分、洼田饮水试验分级高于预后好和预后一般者(P0.05);预后一般者GCS评分低于预后好者,APACHEⅡ评分、NHISS评分、洼田饮水试验分级高于预后好者(P0.05)。结论Apelin-13水平在ACI发病第1天降低,随ACI病程逐渐升高;HSP-70水平在ACI发病第1天升高,随ACI病程逐渐下降。预后差的ACI患者发病第1天的Apelin-13水平、GCS评分低于预后一般和预后好者,而HSP-70水平、APACHEⅡ评分、NHISS评分、洼田饮水试验分级高于预后一般和预后好者,可以根据这些指标的变化判断ACI患者预后。
[Abstract]:Objective to investigate the changes of Apelin-13, stress-related heat shock protein 70 (HSP-70) and 尾 -endorphin (尾 -EP) in patients with acute cerebral infarction (ACI) at different stages and their correlation with prognosis. Methods from January 2013 to December 2014, 50 patients with ACI diagnosed in Shanghai Fifth people's Hospital affiliated to Fudan University were selected as ACI group, and 40 normal subjects were selected as control group. The blood samples of two groups were collected, and the levels of Apelin-13,HSP-70, 尾-EP were measured on the 30th day after the onset of the disease in the control group and the ACI group. The prognosis of the patients with ACI was evaluated according to the modified Rankin grading method. The prognosis was divided into three groups: good prognosis (n = 28), average (n = 15) and poor (n = 7). The level of Apelin-13,HSP-70, 尾 -EP in patients with different prognosis was compared on the first day of onset. Glasgow coma scale (Glasgow coma scale), Acute Physiology and chronic Health scoring system 鈪，

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