ABCD~2评分联合高敏C-反应蛋白、胎盘生长因子、单核细胞趋化因子-1预测短暂性脑缺血发作后短期发生脑梗死的风险

发布时间：2018-01-13 12:35

  本文关键词：ABCD~2评分联合高敏C-反应蛋白、胎盘生长因子、单核细胞趋化因子-1预测短暂性脑缺血发作后短期发生脑梗死的风险　出处：《河北医科大学》2015年硕士论文　论文类型：学位论文

  更多相关文章： 短暂性脑缺血发作 脑梗死 高敏-C反应蛋白 胎盘生长因子 单核细胞趋化因子-1 ABCD2评分 预测

【摘要】：目的:通过ABCD2评分联合高敏C-反应蛋白、胎盘生长因子、单核细胞趋化因子-1在短暂性脑缺血发作初期的浓度水平探讨对短暂性脑缺血发作(Transient Ischemic Attack,TIA)后7d内发生脑梗死(Cerebral Infarction,CI)的预测价值。方法:2014年1月-2015年1月在邯郸市285医院诊断为TIA的符合标准的住院患者90例,根据患者发病后是否发生CI分为两组,CI组22例和非CI组68例,统计所有患者的常见脑血管疾病危险因素、高敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、胎盘生长因子(placenta growth factor,Pl GF)及单核细胞趋化因子-1(monocyte chemottractant protein-1,MCP-1)浓度水平,并进行ABCD2评分。应用单因素分析法比较CI组和非CI组间脑血管疾病常见危险因素、hs-CRP、Pl GF、MCP-1水平及ABCD2评分的差异性。然后进一步将所有患者以hs-CRP≤3mg/L、Pl GF≤20 pg/ml、MCP-1≤245pg/ml和hs-CRP3mg/L、Pl GF20 pg/ml、MCP-1245pg/ml为界进行分层,再根据ABCD2评分≤3分和3分分为两组,以hs-CRP≤3mg/L、Pl GF≤20 pg/ml、MCP-1≤245pg/ml且ABCD2评分≤3分组患者为基线组,其余各组分别与基线组比较,利用Logistic回归的分析方法来评价TIA后短期内发展为CI的发生风险。结果:(1)基线资料单因素分析:CI组平均年龄(65.20±8.6)岁、hs-CRP(6.10±3.51)mg/L、MCP-1(456.60±83.35)pg/ml、Pl GF(25.61±4.77)pg/ml、ABCD2评分(4.68±1.24)均高于非CI组[分别为(61.10±7.6)岁、(3.65±3.52)mg/L、(248.58±58.38)pg/ml、(20.70±4.83)pg/ml、(3.52±1.49)分],两组差异具有统计学意义(P0.05)。(2)Logistic回归结果:hs-CRP3mg/L、MCP-1245pg/ml、Pl GF20pg/ml联合ABCD2评分3分组近期进展为脑梗死的风险是基线组的10.749倍(95%CI为3.419-34.283,P0.05),校正年龄、性别、高血压、糖尿病、家族卒中史和吸烟史后,其TIA患者短期发生脑梗死的危险性升至13.451倍(95%CI为3.221-56.753,P0.05)。结论:ABCD2评分是预测TIA后短期内发生CI的一种简单、有效的工具之一,将高敏-C反应蛋白、胎盘生长因子、单核细胞趋化因子-1与ABCD2评分联合能提高对CI的预测价值。
[Abstract]:Objective: to combine Gao Min C-reactive protein with ABCD2 score and placental growth factor. The concentration of monocyte chemokine 1 in the early stage of transient ischemic attack; to investigate the effect of monocyte chemokine 1 on transient Ischemic Attack in transient ischemic attack. Cerebral Infarction occurred within 7 days after TIA. Methods: from January 2014 to January 2015, 90 inpatients with TIA were diagnosed as TIA. According to whether CI occurred or not, the patients were divided into two groups: 22 cases in CI group and 68 cases in non-CI group. The risk factors of common cerebrovascular diseases in all patients were analyzed. Hypersensitive C-reactive protein (hs-CRP). Placenta growth factor. Pl GF) and monocyte chemokine-1 chemottractant protein-1 (MCP-1). The common risk factors of cerebrovascular disease between CI group and non-CI group were compared by univariate analysis. The difference of MCP-1 level and ABCD2 score. Then all patients were further treated with hs-CRP 鈮，

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