中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2014年
11期
876-879
,共4页
脑缺血发作,短暂性%非对称性二甲基精氨酸%ABCD2评分
腦缺血髮作,短暫性%非對稱性二甲基精氨痠%ABCD2評分
뇌결혈발작,단잠성%비대칭성이갑기정안산%ABCD2평분
Ischemic attack,transient%Asymmetric dimethylarginine%ABCD2 score
目的 探讨血清非对称性二甲基精氨酸(ADMA)与短暂性脑缺血发作(TIA)临床指标及预后之间的关系和临床意义.方法 纳入北京大学第三医院年龄及性别均匹配的40例TIA患者(病例组)和40例健康者(对照组),以ELISA方法测定血清ADMA水平并进行比较.结果 病例组的血清ADMA水平高于对照组[(0.52 ±0.06) mmol/L比(0.23 ±0.04) mmol/L,P＜0.05].亚组分析显示,病例组在TIA发病后3个月随访时发生脑梗死19例(47.5％),其ADMA水平与ABCD2评分呈正相关(r =0.560,P=0.013);病例组既往无卒中史者23例(57.5％),其ADMA水平与ABCD2评分呈正相关(r=0.602,P=0.002).病例组以ABCD2评分3分为界限分为0～3分组和≥4分组,经年龄和性别校正后行一般线性模型分析,结果显示ADMA是ABCD2分组的关联因素(F=4.39,JP=0.043).按有无卒中史、有无发生脑梗死进行分层,无卒中史组经校正年龄、性别、血糖以后,ADMA仍是ABCD2分组强有力的关联因素(F=12.300,P=0.002);发生梗死组ADMA是ABCD2评分强有力的关联因素(F =7.327,P=0.017);有卒中史组(F =0.274,P=0.609)和未发生梗死组(F =0.523,P=0.675)不具有这种关联关系.结论 血清ADMA升高与TIA发病有关,动脉粥样硬化内皮功能不良可能是TIA发病过程中的重要机制.
目的 探討血清非對稱性二甲基精氨痠(ADMA)與短暫性腦缺血髮作(TIA)臨床指標及預後之間的關繫和臨床意義.方法 納入北京大學第三醫院年齡及性彆均匹配的40例TIA患者(病例組)和40例健康者(對照組),以ELISA方法測定血清ADMA水平併進行比較.結果 病例組的血清ADMA水平高于對照組[(0.52 ±0.06) mmol/L比(0.23 ±0.04) mmol/L,P＜0.05].亞組分析顯示,病例組在TIA髮病後3箇月隨訪時髮生腦梗死19例(47.5％),其ADMA水平與ABCD2評分呈正相關(r =0.560,P=0.013);病例組既往無卒中史者23例(57.5％),其ADMA水平與ABCD2評分呈正相關(r=0.602,P=0.002).病例組以ABCD2評分3分為界限分為0～3分組和≥4分組,經年齡和性彆校正後行一般線性模型分析,結果顯示ADMA是ABCD2分組的關聯因素(F=4.39,JP=0.043).按有無卒中史、有無髮生腦梗死進行分層,無卒中史組經校正年齡、性彆、血糖以後,ADMA仍是ABCD2分組彊有力的關聯因素(F=12.300,P=0.002);髮生梗死組ADMA是ABCD2評分彊有力的關聯因素(F =7.327,P=0.017);有卒中史組(F =0.274,P=0.609)和未髮生梗死組(F =0.523,P=0.675)不具有這種關聯關繫.結論 血清ADMA升高與TIA髮病有關,動脈粥樣硬化內皮功能不良可能是TIA髮病過程中的重要機製.
목적 탐토혈청비대칭성이갑기정안산(ADMA)여단잠성뇌결혈발작(TIA)림상지표급예후지간적관계화림상의의.방법 납입북경대학제삼의원년령급성별균필배적40례TIA환자(병례조)화40례건강자(대조조),이ELISA방법측정혈청ADMA수평병진행비교.결과 병례조적혈청ADMA수평고우대조조[(0.52 ±0.06) mmol/L비(0.23 ±0.04) mmol/L,P＜0.05].아조분석현시,병례조재TIA발병후3개월수방시발생뇌경사19례(47.5％),기ADMA수평여ABCD2평분정정상관(r =0.560,P=0.013);병례조기왕무졸중사자23례(57.5％),기ADMA수평여ABCD2평분정정상관(r=0.602,P=0.002).병례조이ABCD2평분3분위계한분위0～3분조화≥4분조,경년령화성별교정후행일반선성모형분석,결과현시ADMA시ABCD2분조적관련인소(F=4.39,JP=0.043).안유무졸중사、유무발생뇌경사진행분층,무졸중사조경교정년령、성별、혈당이후,ADMA잉시ABCD2분조강유력적관련인소(F=12.300,P=0.002);발생경사조ADMA시ABCD2평분강유력적관련인소(F =7.327,P=0.017);유졸중사조(F =0.274,P=0.609)화미발생경사조(F =0.523,P=0.675)불구유저충관련관계.결론 혈청ADMA승고여TIA발병유관,동맥죽양경화내피공능불량가능시TIA발병과정중적중요궤제.
Objective To investigate relationships between serum asymmetric dimethylarginine (ADMA) and transient ischemic attack (TIA).Methods Forty hcalthy controls and 40 patients with TIA were enrolled in the present study.ABCD2 score was used to evaluate risk for future stroke.Serum ADMA levels were measured with ELISA analysis.Results Serum level of ADMA was higher in TIA group than that in control group [(0.52 ± 0.06) mmol/L vs (0.23 ± 0.04) mmol/L,P ＜ 0.05].In TIA subgroup,19 cases(47.5％)developed cerebral infarction and 23 cases(57.5％)had no stroke history.There is positive correlation between serum ADMA levels and ABCD2 score in both cerebral infarction subjects (r =0.560,P =0.013),and no stroke history cases(r =0.602,P =0.002).TIA subjects were,then,divided in to two groups based on ABCD2 score as 0-3 group and ≥ 4 group.In general linear model analysis,ADMA level was associated with ABCD2 score (F =4.39,P =0.043) after adjusted for age and gender.This situation hold true for subjects within cerebral infarction group (F =7.327,P =0.017) or non-previous stroke group(F =12.300,P =0.002).No association could bc found between ADMA level and ABCD2 score grouping in subjects with non-infarct (F =0.523,P =0.675) or stroke history (F =0.274,P =0.609).Conclusions Elevated ADMA is associated with occurrence of TIA.Endothelial dysfunction may play an important role in the pathogenesis of TIA.
