CAJ | 학술논문

目的：分析不同程度的颅内动脉狭窄患者的既往史和血清亲环素 A 和网膜素水平的差异,并探讨颅内动脉狭窄的危险因素和亲环素 A、网膜素与颅内动脉狭窄程度的关系。方法收集89例脑梗死患者临床资料,将患者分为颅内动脉多发狭窄组(n=29)、颅内动脉单发狭窄组(n=24)和对照组(n=36),应用ELISA 方法测定血清亲环素 A 和网膜素水平。比较3组间既往史、血清亲环素 A 和网膜素水平的差异。结果在颅内动脉多发狭窄组、单发狭窄组、对照组既往史的比较中糖尿病史和既往脑卒中史具有显著差异(50.0% vs 29.2% vs 13.9%,P <0.017；58.6% vs 29.2% vs 27.8%,P <0.017),颅内动脉多发狭窄组的患者合并糖尿病史、既往脑卒中史的概率比另2组的概率显著增高；3组中血清亲环素 A 水平有显著差异[(11.040±3.166)ng/ml vs (7.984±4.550)ng/ml vs (2.433±2.433)ng/ml,P <0.05],颅内动脉多发狭窄组较颅内动脉单发狭窄组患者的血清亲环素 A 水平升高,且二者与对照组比较均有升高(P <0.05)；与对照组相比较,颅内动脉多发狭窄组和颅内动脉单发狭窄组血清网膜素-1水平均有降低[(0.088±0.046)ng/ml vs (0.290±0.245)ng/ml,P <0.05；(0.242±0.182)ng/ml vs (0.290±0.245)ng/ml,P <0.05],但二者之间血清网膜素水平无显著差异(P <0.05)。结论患有糖尿病史或既往脑卒中史的患者更容易合并颅内动脉狭窄,糖尿病、既往脑卒中史可能是颅内动脉狭窄的危险因素；颅内动脉多发狭窄组血清亲环素 A 水平明显升高、网膜素水平明显降低,提示亲环素 A 可能参与颅内动脉狭窄的形成；血清网膜素水平与颅内动脉硬化狭窄有关,但与狭窄程度无关,提示颅内动脉狭窄患者可能存在内皮功能的受损。
목적：분석불동정도적로내동맥협착환자적기왕사화혈청친배소 A 화망막소수평적차이,병탐토로내동맥협착적위험인소화친배소 A、망막소여로내동맥협착정도적관계。방법수집89례뇌경사환자림상자료,장환자분위로내동맥다발협착조(n=29)、로내동맥단발협착조(n=24)화대조조(n=36),응용ELISA 방법측정혈청친배소 A 화망막소수평。비교3조간기왕사、혈청친배소 A 화망막소수평적차이。결과재로내동맥다발협착조、단발협착조、대조조기왕사적비교중당뇨병사화기왕뇌졸중사구유현저차이(50.0% vs 29.2% vs 13.9%,P <0.017；58.6% vs 29.2% vs 27.8%,P <0.017),로내동맥다발협착조적환자합병당뇨병사、기왕뇌졸중사적개솔비령2조적개솔현저증고；3조중혈청친배소 A 수평유현저차이[(11.040±3.166)ng/ml vs (7.984±4.550)ng/ml vs (2.433±2.433)ng/ml,P <0.05],로내동맥다발협착조교로내동맥단발협착조환자적혈청친배소 A 수평승고,차이자여대조조비교균유승고(P <0.05)；여대조조상비교,로내동맥다발협착조화로내동맥단발협착조혈청망막소-1수평균유강저[(0.088±0.046)ng/ml vs (0.290±0.245)ng/ml,P <0.05；(0.242±0.182)ng/ml vs (0.290±0.245)ng/ml,P <0.05],단이자지간혈청망막소수평무현저차이(P <0.05)。결론환유당뇨병사혹기왕뇌졸중사적환자경용역합병로내동맥협착,당뇨병、기왕뇌졸중사가능시로내동맥협착적위험인소；로내동맥다발협착조혈청친배소 A 수평명현승고、망막소수평명현강저,제시친배소 A 가능삼여로내동맥협착적형성；혈청망막소수평여로내동맥경화협착유관,단여협착정도무관,제시로내동맥협착환자가능존재내피공능적수손。
Objective To explore the risk factors of intracranial stenosis and the relationship among cy-clophilin-A ,omentin and the development of intracranial atherosclerosis by analyzing the variations of previous history,serum cyclophilin-A levels and serum omentin levels in different levels of patients with intracranial ar-tery stenosis.Methods Collectting clinical data of 89 patients with cerebral infarctions,which are divided into multiple intracranial artery stenosis group (n=29),isolated intracranial artery stenosis group (n=24)and the control group (n=36),and assessing serum cyclophilin-A levels and serum omentin levels by ELISA.Results History of diabetes mellitus and previous stroke have significant difference among multiple intracranial artery stenosis group,isolated intracranial artery stenosis group and the control group (50.0% vs 29.2% vs 13.9%, P <0.01 7;58.6% vs 29.2% vs 27.8%,P <0.01 7),Patients in multiple intracranial artery stenosis group have the higher possibility with diabetes mellitus and history of previous stroke than the other two groups.Ser-um cyclophilin-A levels has a significance in these three groups [(1 1 .040±3.166)ng/ml vs (7.984±4.550) ng/ml vs (2.433±2.433 ng/ml,P <0.05],which is the highest in multiple intracranial artery stenosis group and the lowest in control group.Compared with the control group ,serum omentin levels in multiple intracrani-al artery stenosis group and isolated intracranial artery stenosis group are lower [(0.088 ±0.046)ng/ml vs (0.290±0.245)ng/ml,P <0.05,(0.242±0.1 82)ng/ml vs (0.290±0.245)ng/ml,P <0.05],but there is no significance difference between multiple intracranial artery stenosis group and isolated intracranial artery stenosis group.Conclusions Patients with history of diabetes mellitus or preious stroke are more likely to get intracranial artery stenosis ,so diabetes mellitus and previous stroke could be the risk factors of intracranial ar-tery stenosis ;Patients in Multiple intracranial artery stenosis group have the higher Serum cyclophilin-A levels and lower serum omentin levels ,which indicats that cyclophilin-A may has the possibility of being involved in the formation and development of intracranial atherosclerosis .Serum omentin levels is associated with in-tracranial artery stenosis,but has no relevance with the number of narrows ,which shows that there may be endothelial dysfuntion in patients with intracranial artery stenosis.