国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2012年
10期
732-738
,共7页
谢玉%刘煜敏%孔朝红%周绍霞%李芹
謝玉%劉煜敏%孔朝紅%週紹霞%李芹
사옥%류욱민%공조홍%주소하%리근
脂肪酸结合蛋白%脂肪细胞%脂联素%卒中%脑缺血
脂肪痠結閤蛋白%脂肪細胞%脂聯素%卒中%腦缺血
지방산결합단백%지방세포%지련소%졸중%뇌결혈
Fatty Acid-Binding Proteins%Adipocytes%Adiponectin%Stroke%Brain Ischemia
目的 探讨血清脂肪细胞型脂肪酸结合蛋白(adipocyte fatty acid-binding protein,A-FABP)、脂联素(adip onectin,APN)及A-FABP/APN比值与急性缺血性卒中(acute ischemic stroke,AIS)及其亚型的相关性.方法 连续纳入于发病24 h内入院且资料完整的AIS患者(AIS组),并选取同时期年龄、性别、体质指数与AIS组匹配的健康体检者作为对照组.收集AIS组和对照组人口统计学特征和一般临床资料.采用酶联免疫吸附试验检测血清A-FABP和APN水平.根据TOAST分型标准将AIS组患者进一步分为大动脉粥样硬化性卒中(large artery atherosclerosis,LAA)、小动脉闭塞性卒中(small artery occlusion,SAO)、心源性脑栓塞(cardioembolism,CE)、其他原因明确的卒中(stroke of other determined etiology,SOE)以及原因不明性卒中(stroke of undetermined etiology,SUE).采用多变量logistic回归分析探讨各因素与AIS及其亚型的关系.采用Spearman相关分析分析A-FABP和APN水平与NIHSS评分的相关性.结果 AIS组血清A-FABP水平(P=0.017)和A-FABP/APN比值(P =0.002)显著高于对照组,而血清APN水平则显著低于对照组(P=0.011).多变量logistic回归分析显示,血清A-FABP水平[优势比(odds ratio,OR)1.48,95％可信区间(confidence interval,CI) 1.07～1.93;P=0.009]和A-FABP/APN比值(OR 1.59,95％口1.10～2.34;P=0.002)增高以及APN水平降低(OR 0.36,95％ CI 0.14～0.65;P=0.011)与AIS独立相关,且A-FABP/APN比值较二者单独时的相关性更好.LAA、SAO和CE组血清A-FABP水平和A-FABP/APN比值显著高于其他亚型组(P均＜0.05),而APN水平则显著低于其他亚型组(P＜0.05).多变量logistic回归分析显示,血清A-FABP水平和A-FABP/APN比值增高以及APN水平降低与LAA、SAO和CE独立相关,且A-FABP/APN比值较二者单独时的相关性更好.AIS组基线NIHSS评分与血清A-FABP水平呈显著正相关(r=0.236,P=0.019),与血清APN水平呈显著负相关(r=-0.307,P=0.002),与血清A-FABP/APN比值的相关性高于A-FABP或APN(r=0.326,P=0.001).结论 血清A-FABP水平增高和APN水平降低可能作为AIS,特别是LAA、SAO和CE亚型AIS的新型危险因素,而且能反映AIS严重程度.
目的 探討血清脂肪細胞型脂肪痠結閤蛋白(adipocyte fatty acid-binding protein,A-FABP)、脂聯素(adip onectin,APN)及A-FABP/APN比值與急性缺血性卒中(acute ischemic stroke,AIS)及其亞型的相關性.方法 連續納入于髮病24 h內入院且資料完整的AIS患者(AIS組),併選取同時期年齡、性彆、體質指數與AIS組匹配的健康體檢者作為對照組.收集AIS組和對照組人口統計學特徵和一般臨床資料.採用酶聯免疫吸附試驗檢測血清A-FABP和APN水平.根據TOAST分型標準將AIS組患者進一步分為大動脈粥樣硬化性卒中(large artery atherosclerosis,LAA)、小動脈閉塞性卒中(small artery occlusion,SAO)、心源性腦栓塞(cardioembolism,CE)、其他原因明確的卒中(stroke of other determined etiology,SOE)以及原因不明性卒中(stroke of undetermined etiology,SUE).採用多變量logistic迴歸分析探討各因素與AIS及其亞型的關繫.採用Spearman相關分析分析A-FABP和APN水平與NIHSS評分的相關性.結果 AIS組血清A-FABP水平(P=0.017)和A-FABP/APN比值(P =0.002)顯著高于對照組,而血清APN水平則顯著低于對照組(P=0.011).多變量logistic迴歸分析顯示,血清A-FABP水平[優勢比(odds ratio,OR)1.48,95％可信區間(confidence interval,CI) 1.07～1.93;P=0.009]和A-FABP/APN比值(OR 1.59,95％口1.10～2.34;P=0.002)增高以及APN水平降低(OR 0.36,95％ CI 0.14～0.65;P=0.011)與AIS獨立相關,且A-FABP/APN比值較二者單獨時的相關性更好.LAA、SAO和CE組血清A-FABP水平和A-FABP/APN比值顯著高于其他亞型組(P均＜0.05),而APN水平則顯著低于其他亞型組(P＜0.05).多變量logistic迴歸分析顯示,血清A-FABP水平和A-FABP/APN比值增高以及APN水平降低與LAA、SAO和CE獨立相關,且A-FABP/APN比值較二者單獨時的相關性更好.AIS組基線NIHSS評分與血清A-FABP水平呈顯著正相關(r=0.236,P=0.019),與血清APN水平呈顯著負相關(r=-0.307,P=0.002),與血清A-FABP/APN比值的相關性高于A-FABP或APN(r=0.326,P=0.001).結論 血清A-FABP水平增高和APN水平降低可能作為AIS,特彆是LAA、SAO和CE亞型AIS的新型危險因素,而且能反映AIS嚴重程度.
목적 탐토혈청지방세포형지방산결합단백(adipocyte fatty acid-binding protein,A-FABP)、지련소(adip onectin,APN)급A-FABP/APN비치여급성결혈성졸중(acute ischemic stroke,AIS)급기아형적상관성.방법 련속납입우발병24 h내입원차자료완정적AIS환자(AIS조),병선취동시기년령、성별、체질지수여AIS조필배적건강체검자작위대조조.수집AIS조화대조조인구통계학특정화일반림상자료.채용매련면역흡부시험검측혈청A-FABP화APN수평.근거TOAST분형표준장AIS조환자진일보분위대동맥죽양경화성졸중(large artery atherosclerosis,LAA)、소동맥폐새성졸중(small artery occlusion,SAO)、심원성뇌전새(cardioembolism,CE)、기타원인명학적졸중(stroke of other determined etiology,SOE)이급원인불명성졸중(stroke of undetermined etiology,SUE).채용다변량logistic회귀분석탐토각인소여AIS급기아형적관계.채용Spearman상관분석분석A-FABP화APN수평여NIHSS평분적상관성.결과 AIS조혈청A-FABP수평(P=0.017)화A-FABP/APN비치(P =0.002)현저고우대조조,이혈청APN수평칙현저저우대조조(P=0.011).다변량logistic회귀분석현시,혈청A-FABP수평[우세비(odds ratio,OR)1.48,95％가신구간(confidence interval,CI) 1.07～1.93;P=0.009]화A-FABP/APN비치(OR 1.59,95％구1.10～2.34;P=0.002)증고이급APN수평강저(OR 0.36,95％ CI 0.14～0.65;P=0.011)여AIS독립상관,차A-FABP/APN비치교이자단독시적상관성경호.LAA、SAO화CE조혈청A-FABP수평화A-FABP/APN비치현저고우기타아형조(P균＜0.05),이APN수평칙현저저우기타아형조(P＜0.05).다변량logistic회귀분석현시,혈청A-FABP수평화A-FABP/APN비치증고이급APN수평강저여LAA、SAO화CE독립상관,차A-FABP/APN비치교이자단독시적상관성경호.AIS조기선NIHSS평분여혈청A-FABP수평정현저정상관(r=0.236,P=0.019),여혈청APN수평정현저부상관(r=-0.307,P=0.002),여혈청A-FABP/APN비치적상관성고우A-FABP혹APN(r=0.326,P=0.001).결론 혈청A-FABP수평증고화APN수평강저가능작위AIS,특별시LAA、SAO화CE아형AIS적신형위험인소,이차능반영AIS엄중정도.
Objective To investigate the correlations of serum adipocyte fatty acid-binding protein (AFABP),adiponectin (APN) and A-FABP/APN ratio with acute ischemic stroke (AIS) and its subtypes.Methods The consecutive patients with AIS (AIS group) of having complete data admitted within 24 hours of onset were enrolled,and at the same time,the healthy subjects of age,sex and body mass index matched with the AIS group were selected as a control group.The demographic characteristics and general clinical data of the AIS group and control group were collected.The serum A-FABP and APN levels were detected by enzymelinked immunosorbent assay.The patients in the AIS group were further divided into large artery atherosclerosis (LAA),small artery occlusion,(SAO),cardioembolism (CE),and stroke of other determined etiology (SOE) according to the TOAST classification criteria.Multivariable logistic regression analysis was used to investigate the relationship between all factors and AIS and its subtypes.Spearman correlation analysis was used to analyze the correlations of the A-FABP and APN levels and the NIHSS scores.Results The serum A-FABP level (P =0.017) and A-FABP/APN ratio (P =0.002) in the AIS group were significantly higher than those in the control group,and the serum APN level was significantly lower than that in the control group (P =0.011).Multivariate logistic regression analysis showed that the increased serum A-FABP level (odds ratio [OR] 1.48,95％ confidence interval [CI] 1.07-1.93; P =0.009) and the A-FABP/APN ratio (OR 1.59,95％ CI 1.10-2.34; P =0.002) as well as the decreased APN level (OR 0.36,95％ CI 0.14-0.65; P =0.011) were independently associated with AIS.And the A-FABP/APN ratio was better than the correlation of both separately.The serum A-FABP level and A-FABP/APN ratio in the LAA,SAO and CE groups were significantly higher than those in other subtype groups (all P ＜0.05),and the APN level was significantly lower than that in other subtype groups (P ＜0.05).Multivariate logistic regression analysis showed that the increased serum A-FABP level and A-FABP/APN ratio as well as the decreased APN level were independently associated with LAA,SAO and CE,and the A-FABP/APN ratio was better than the correlation of both separately.The baseline NIHSS score was positively correlated with the serum A-FABP level (r =0.236,P =0.019),it was negatively correlated with the serum APN level (r =0.307,P =0.002),and the correlation of the serum AFABP/APN ratio was higher than that of A-FABP or APN (r =0.326,P =0.001).Conclusions The increased serum A-FABP level and the decreased APN level may serve as the new risk factors for AIS,especially LAA,SAO and CE subtypes,and they can reflect the severity of AIS.
