血清A-FABP与脑梗死患者颈动脉粥样硬化的相关性

发布时间：2018-05-05 06:30

本文选题：脂肪细胞型脂肪酸结合蛋白 + 脑梗死　；参考：《山西医科大学》2014年硕士论文

【摘要】：目的：通过比较脑梗死组与非脑梗死组以及颈动脉无斑块组、稳定斑块组、不稳定斑块组组间血清脂肪细胞型脂肪酸结合蛋白(A-FABP)水平,探讨血清A-FABP水平与脑梗死的发生、颈动脉粥样硬化斑块的形成及不稳定性的关系,评价A-FABP作为脑梗死、颈动脉粥样硬化斑块形成及斑块不稳定的临床预测因素的价值。方法：根据入选标准选取急性脑梗死患者67例(脑梗死组),对照组31例(非脑梗死者),所有受试者通过颈动脉彩色多普勒超声检查测定颈动脉内中膜厚度(IMT)并观察颈动脉粥样硬化斑块的数目及回声情况。根据有无斑块及斑块的性质将脑梗死组分为无斑块组、稳定斑块组、不稳定斑块组。所有受试者均抽取空腹肘静脉血,检测血清A-FABP、TC、 TG、LDL-C、HDL-C、FPG水平。结果：1.脑梗死与对照组比较显示：单因素分析：血清A-FABP(t=6.224)与高血压病构成比(χ2=26.624)、糖尿病构成比(χ2=19.817)、血清TG(t=3.432)水平、血清TC(t=2.230)水平、血清LDL-C(t=4.372)水平、血清HDL-C(t=-5.496)水平、颈动脉斑块检出率(χ2=34.765)、颈动脉斑块检出率(χ2=28.441)一样都与脑梗死有关,差异性均有统计学意义(P0.05)；多变量logistic逐步回归分析：血清A-FABP水平(OR=3.165),血清LDL-C水平(OR=5.756,血清HDL-C水平(OR=0.249),高血压病(OR=6.403),糖尿病(OR=34.878),P值均0.05。 2.无斑块组、稳定斑块组、不稳定斑块组比较显示：血清A-FABP(t=6.467)与高血压病构成比(χ2=6.586)、糖尿病构成比(χ2=6.296)、血清TG(t=3.385)水平、血清TC(t=3.336)水平、血清LDL-C(t=4.917)水平、血清HDL-C(t=6.540)水平与颈动脉粥样硬化斑块形成及不稳定性有关,差异均有统计学意义(P0.05)；多变量logistic逐步回归分析：血清4-FABP水平(OR=2.147),血清LDL-C水平(OR=4.267),血清HDL-C水平(OR=0.160),高血压病(OR=5.590),糖尿病(OR=6.469),P值均0.05。 3.血清A-FABP水平与TG、TC、HDL-C、LDL-C、FPG进行相关分析显示：血清A-FABP水平与TG(r=0.472)、TC(r=0.331)、LDL-C(r=0.502)呈正相关,与HDL-Cr=-0.537)呈负相关；偏相关分析示：血清A-FABP水平与TG(r=0.209)、LDL-C(r=0.380)呈正相关,与HDL-C(r=-0.481)呈负相关,P0.05。结论：1.血清A-FABP水平与血脂代谢、颈动脉粥样硬化斑块形成及斑块的不稳定性有关,从而与脑梗死的发生相关。 2.血清A-FABP增高可能是脑梗死及颈动脉粥样硬化形成的危险因素。 3.血清A-FABP可能是脑梗死、颈动脉粥样硬化斑块形成及斑块不稳定的临床预测因素。
[Abstract]:Objective: to compare the serum levels of adipocyte fatty acid binding protein (FFABP) between cerebral infarction group and non-cerebral infarction group, carotid artery without plaque group, stable plaque group and unstable plaque group, and to explore the relationship between serum A-FABP level and cerebral infarction. To evaluate the value of A-FABP as a clinical predictor of cerebral infarction, carotid atherosclerotic plaque formation and plaque instability. Methods: according to the inclusion criteria, 67 patients with acute cerebral infarction (cerebral infarction group) and 31 control group (non-cerebral infarction patients) were selected and observed by carotid artery color Doppler ultrasonography for carotid intima media thickness (IMT). The number and echo of carotid atherosclerotic plaques were examined. According to the plaque and the character of plaque, the cerebral infarction group was divided into three groups: no plaque group, stable plaque group and unstable plaque group. All subjects were collected from fasting cubital vein blood to detect the levels of serum A-FABPnTC, TGD-LDL-C+ HDL-CfPG. The result is 1: 1. Compared with the control group, single factor analysis showed that the ratio of serum A-FABPtU 6.224) to hypertension (蠂 2 + 26.624), diabetes mellitus (蠂 2 + 19.817), serum TGN (3.43 2), serum TCU (2.230), serum LDL-Ctn (4.372), serum HDL-CntU (-5.496). The detection rate of carotid plaques (蠂 ~ 2 ~ 2 ~ (34.765)) and carotid plaques (蠂 ~ (2) ~ (2) ~ (28) 441) were all related to cerebral infarction. Multivariate logistic stepwise regression analysis showed that the serum A-FABP level was 3.165%, the serum LDL-C level was 5.756, the serum HDL-C level was 0.249%, the hypertension was 6.403%, the diabetes mellitus was 34.878 P value. 2. The results showed that the ratio of serum A-FABPtX 6.467 to hypertension, diabetes mellitus (蠂 2) 6.296%, serum TGN 3.336%, serum TCU ~ (3 36) and LDL-C ~ (2 +) 4.917 were higher than those in control group (蠂 ~ 2 = 6.296), stable plaque group and unstable plaque group (P < 0.05), compared with those in non-plaque group (P < 0.05), stable plaque group and unstable plaque group (P < 0.05), compared with those of hypertension (蠂 ~ 2 = 6.586). The multivariate logistic stepwise regression analysis showed that the serum 4-FABP level was 2.147%, the serum LDL-C level was 4.267%, the serum HDL-C level was 0.160%, the hypertension OR5.590%, the diabetes 6.469m P 0.050.The serum HDL-ct level was related to the formation and instability of carotid atherosclerotic plaques (P < 0.05), and the multivariate logistic stepwise regression analysis showed that the serum 4-FABP level was 2.147%, the serum LDL-C level was 4.267%, the serum HDL-C level was 0.160, the hypertension OR5.590%, and the DM 6.469m P values were 0.05. 3. The correlation analysis between serum A-FABP level and A-FABP level showed that the level of serum A-FABP was positively correlated with TGR 0.472 and negatively correlated with HDL-Cr-0.537), and the level of serum A-FABP was positively correlated with TGR 0.209 LDL-Cnr 0.380, and negatively correlated with HDL-Cr-0.481LDL-Cr-0.537), and negatively correlated with HDL-Cr-0.481 (P 0.05). Conclusion 1. Serum A-FABP level was related to lipid metabolism, carotid atherosclerotic plaque formation and plaque instability, which was related to the occurrence of cerebral infarction. 2. Elevated serum A-FABP may be a risk factor for cerebral infarction and carotid atherosclerosis. 3. Serum A-FABP may be a clinical predictor of cerebral infarction, carotid atherosclerotic plaque formation and plaque instability.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

【参考文献】