1、高血压脑出血、脑梗特征性蛋白标志物研究 2、低水平甘油三酯增加脑出血患者全因死亡风险
发布时间：2019-05-14 12:46
【摘要】：研究背景及目的脑卒中在中国已成为第一位死亡原因,是一种危害性极大的疾病,具有极高的病死率和致残率,造成重大健康负担。尽管已经有很多研究揭示了脑卒中后的病理变化和治疗方案,其发病机制尚未阐明。在高血压条件下,脑血管病变引起不同类型的脑卒中的机制仍不明确。本文试图通过血浆蛋白质组学方法,鉴定高血压脑梗死与高血压脑出血患者的表达差异蛋白,发现相关的信号通路,提供潜在的新型蛋白标志物。研究方法本研究前瞻性入选正常受试者(n=15),单纯高血压患者(n=15),高血压脑梗死患者(n=15)和高血压脑出血患者(n=15),收集受试者资料和静脉血标本。基于TMT-LC-MS/MS蛋白质组学方法,对4组血浆样本进行质谱鉴定和定量比较,发现差异蛋白,进行生物信息学分析,筛选可能与高血压脑梗死(Hypertensive Cerebral Infarction,HCI)或者高血压脑出血(Hypertensive Intracerebral Hemorrhage,HICH)相关的信号通路和特异蛋白质。研究结果采用高通量TMT标记方法对血浆蛋白进行定量,总共找到了 191种蛋白和712个肽段。将正常组作对照,有53个蛋白至少在一个组中有两倍或两倍以上的上调或者下调的表达差异。其中,HCI组有21种上调蛋白和14种下调蛋白,HICH组有30种上调蛋白和14种下调蛋白。将高血压组作为对照,有38个蛋白至少在一个组中有两倍或两倍以上的上调或者下调的表达差异。其中,HCI组有12种上调蛋白和14种下调蛋白,HICH组有18种上调蛋白和13种下调蛋白。通过GO富集和KEGG分析发现,HICH组所涉及的信号通路与炎症反应、补体结合相关,而HCI组所涉及的信号通路与免疫反应相关。结论HICH组与HCI组之间存在明显的蛋白质差异,为高血压脑出血、脑梗的预警和防治提供新的线索。研究目的探究脑出血患者甘油三酯水平与全因死亡的相关性。研究方法本研究入选2000年至2001年期间467例经颅脑CT或核磁共振确诊为脑出血的患者并平均随访4.5年。依据甘油三酯(Triglyceride,TG)浓度是否在正常参考值范围将患者分为TG≤1.7mmol/L组(n=280)和TG1.7mmol/L组(n=187)。采集患者基线资料和静脉血标本,分析其基线资料和预后。终点事件为长期随访全因死亡。结果467例脑出血患者长期随访中死亡110例,全因死亡率为23.6%。TG≤1.7 mmol/L组的全因死亡率(30%,84/280)明显高于TG1.7mmol/L组(13.9%,26/110),差异有统计学意义(logrankP0.001)。单因素Cox回归分析显示 TG≤1.7mmol/L 增加死亡风险 2.341 倍(HR=2.341,95%CI 1.508～3.635,P=0.001)。经多因素Cox因素分析校正年龄和性别等因素后,TG≤1.7mmol/L增加死亡风险(HR=1.984,95%CI 1.258～3.13,P=0.003)。结论TG≤1.7 mmol/L增加脑出血患者全因死亡风险。
[Abstract]:Background and objective Stroke has become the first cause of death in China, is a very harmful disease, with a very high mortality and disability rate, resulting in a major health burden. Although many studies have revealed pathological changes and treatment after stroke, the pathogenesis has not yet been clarified. Under the condition of hypertension, the mechanism of different types of stroke caused by cerebrovascular disease is still unclear. This paper attempts to identify the differential proteins expressed in patients with hypertensive cerebral infarction and hypertensive intracerebral hemorrhage by plasma proteome method, to find out the related signal pathways, and to provide a potential new protein marker. Methods the data and venous blood samples of normal subjects (n 鈮，
本文编号：2476729
[Abstract]:Background and objective Stroke has become the first cause of death in China, is a very harmful disease, with a very high mortality and disability rate, resulting in a major health burden. Although many studies have revealed pathological changes and treatment after stroke, the pathogenesis has not yet been clarified. Under the condition of hypertension, the mechanism of different types of stroke caused by cerebrovascular disease is still unclear. This paper attempts to identify the differential proteins expressed in patients with hypertensive cerebral infarction and hypertensive intracerebral hemorrhage by plasma proteome method, to find out the related signal pathways, and to provide a potential new protein marker. Methods the data and venous blood samples of normal subjects (n 鈮，
本文编号：2476729
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