CAJ | 학술논문

目的探讨老年急性脑梗死患者血清白细胞介素6（IL -6）、基质金属蛋白酶9（MMP -9）、淀粉样酶 A （SAA）、超敏 C 反应蛋白（hs - CRP）及视黄醇结合蛋白4（RBP4）水平与其预后的关系。方法收集2012年1月至2014年1月诊断为急性脑梗死的老年住院患者86例，设为观察组，另选健康人群40例作为对照组，比较两组之间血清IL -6、MMP -9、SAA、hs - CRP 及 RBP4水平。另根据患者 NIHSS 评分，将观察组患者分为神经功能损害轻度组、中度组和重度组，比较三组之间血清 IL -6、MMP -9、SAA、hs - CRP 及 RBP4水平，并根据 NIHSS 评分比较三组间预后良好率、进展性脑卒中率和病死率。结果与对照组比较，观察组患者血清 IL -6、MMP -9、SAA、hs - CRP 及 RBP4水平均升高，差异有统计学意义（ P ﹤0.05）；观察组神经功能损害轻度组、中度组和重度组间比较，血清 IL -6、MMP -9、SAA、hs - CRP 及 RBP4水平逐渐升高，差异有统计学意义（ P ﹤0.05），三组间性 Pearson 相关性分析，差异有统计学意义（ P﹤0.05）。另外，与轻度组比较，中度组和重度组预后良好率明显降低，进展性脑卒中率明显增高，病死率明显增高，除轻度组与中度组病死率无明显差异外，其余各项组间比较差异均有统计学意义（ P ﹤0.05）。结论老年急性脑梗死患者血清 IL -6、MMP -9、SAA、hs - CRP 及 RBP4水平显著升高，且与病情严重程度呈正相关关系，故可作为判断病情的实验室指标。由于老年急性脑梗死的预后与病情程度密切相关，故血清 IL -6、MMP -9、SAA、hs - CRP 及 RBP4水平也可作为判断预后的指标，对其进行检测和干预有助于对预后的判断和改善。
목적탐토노년급성뇌경사환자혈청백세포개소6（IL -6）、기질금속단백매9（MMP -9）、정분양매 A （SAA）、초민 C 반응단백（hs - CRP）급시황순결합단백4（RBP4）수평여기예후적관계。방법수집2012년1월지2014년1월진단위급성뇌경사적노년주원환자86례，설위관찰조，령선건강인군40례작위대조조，비교량조지간혈청IL -6、MMP -9、SAA、hs - CRP 급 RBP4수평。령근거환자 NIHSS 평분，장관찰조환자분위신경공능손해경도조、중도조화중도조，비교삼조지간혈청 IL -6、MMP -9、SAA、hs - CRP 급 RBP4수평，병근거 NIHSS 평분비교삼조간예후량호솔、진전성뇌졸중솔화병사솔。결과여대조조비교，관찰조환자혈청 IL -6、MMP -9、SAA、hs - CRP 급 RBP4수평균승고，차이유통계학의의（ P ﹤0.05）；관찰조신경공능손해경도조、중도조화중도조간비교，혈청 IL -6、MMP -9、SAA、hs - CRP 급 RBP4수평축점승고，차이유통계학의의（ P ﹤0.05），삼조간성 Pearson 상관성분석，차이유통계학의의（ P﹤0.05）。령외，여경도조비교，중도조화중도조예후량호솔명현강저，진전성뇌졸중솔명현증고，병사솔명현증고，제경도조여중도조병사솔무명현차이외，기여각항조간비교차이균유통계학의의（ P ﹤0.05）。결론노년급성뇌경사환자혈청 IL -6、MMP -9、SAA、hs - CRP 급 RBP4수평현저승고，차여병정엄중정도정정상관관계，고가작위판단병정적실험실지표。유우노년급성뇌경사적예후여병정정도밀절상관，고혈청 IL -6、MMP -9、SAA、hs - CRP 급 RBP4수평야가작위판단예후적지표，대기진행검측화간예유조우대예후적판단화개선。
Objective To study the relationship between the levels of serum IL - 6,MMP - 9,SAA,hsCRP,RBP4 and the prognosis of elderly patients with acute cerebral infarction. Methods 86 patients with acute cerebral infarction since January 2012 to January 2014 were in-volved as observation group,40 healthy cases were involved as control group. The serum level of IL - 6,MMP - 9,SAA,hsCRP and RBP4 of both groups were compared. In addition,the observation group were divided into mild,moderate group and severe group according to the NIHSS score. The serum IL - 6,MMP - 9,SAA,hsCRP and RBP4 level,as well as good prognosis rate,stroke rate and mortality,were compared be-tween three groups. Results Compared with control group,the serum IL - 6,MMP - 9,SAA,hsCRP and RBP4 levels of observation group were higher. The difference was statistically significant( P ﹤ 0. 05). Serum levels of IL - 6,MMP - 9,SAA,hsCRP and RBP4 level of the three groups in observation group were increased gradually. The difference was statistically significant( P ﹤ 0. 05). The pearson correlation is also statis-tically significant among the three groups( P ﹤ 0. 05). In addition,the good prognosis rate,stroke rate and mortality rate of three groups were dif-ferent. The difference was statistically significant( P ﹤ 0. 05). Conclusion The serum IL - 6,MMP - 9,SAA,hsCRP and RBP4 levels of eld-erly patients with acute cerebral infarction were obviously increased and positively correlated with disease severity. Therefore,these indexes can be used as a judging index of laboratory. Moreover,the prognosis of elderly acute cerebral infarction is closely related to the degree of illness. There-fore,the serum IL - 6,MMP - 9,SAA,hsCRP and RBP4 level can be used as a prognosis indicators,the detection and intervention ,which will help to judge and improve the prognosis.