血清淀粉样蛋白A与缺血性脑卒中及亚型的相关性研究

目的探讨血清淀粉样蛋白A(SAA)与缺血性脑卒中(IS)及亚型的发生风险及严重程度的相关性。方法纳入130例IS患者,根据2007年的改良TOAST分型标准对IS进行病因学分型,其中动脉粥样硬化血栓形成脑卒中(AT)79例、心源性栓塞(CE)20例、穿支小动脉闭塞(SAD)26例,不明原因5例;同期纳入145例同社区、年龄匹配的无心脑血管病的受试者作为对照组。记录所有纳入对象的IS相关危险因素及影响SAA水平的潜在因素。采用酶联免疫吸附法检测血清SAA水平,应用Logistic回归分析SAA水平与IS、IS亚型及美国国立卫生院神经功能缺损评分(NIHSS)的相关性。结果病例组SAA水平高于对照组〔(10.15±5.21)ng/mLvs(8.83±3.82)ng/mL,P<0.05〕;SAA四分位水平最高组(>10.77ng/mL)发生IS风险是最低组(≤6.33ng/mL)的1.83倍(95%CI1.13～2.18,P=0.025)。AT组SAA水平高于对照组(OR=1.62,95%CI 1.05～1.89,P=0.029),校正相关危险因素后其差异仍有统计学意义(OR=1.43,95%CI1.01～1.71,P=0.034)。在NIHSS>15分的IS患者中,SAA四分位水平最高组严重程度是最低组风险的2.13倍(95%CI 1.34～3.69,P=0.043)。结论 SAA是一种新型的炎性反应标志物,可预测IS发生风险及严重程度。

Association between ischemic stroke and serum amyloid A protein

Objective To explore the association of serum amyloid A protein(SAA) and the risk and severity of ischemic stroke(IS) and its subtypes.Methods The serum SAA level was detected in 130 IS patients and 145 controls without history of vascular diseases.According to 2007 modified TOAST criteria,the patients were divided into 4 types,atherothrombosis stroke(AT,n=79),cardioembolism(CE,n=20),small artery disease(SAD,n=26)and stroke of undetermined etiology(SUD,n=5).All the related risk factors for IS and potential elements affecting SAA level were recorded.The serum SAA level was detected by enzyme-linked immunosorbent assay(ELISA).The associations of SAA level and IS,IS subtypes and the National Institutes of Health Stroke Scale(NIHSS) were analyzed by logistic regression.Results The SAA level of the patients were higher than the controls [(10.15±5.21)ng/mL vs(8.83±3.82)ng/mL,P<0.05)].IS risk in the highest quartile SAA level group(>10.77 ng/mL)was 1.83 folds of that in the lowest quartile group(≤6.33 ng/mL)(OR=1.83,95%CI 1.13-2.18,P=0.025).SAA level of the AT group was higher than that of the control group(OR=1.62,95%CI 1.05-1.89,P=0.029),and the difference was still present after the correction of related risk factors(OR=1.43,95%CI 1.01-1.71,P=0.034).In IS patients(NIHSS>15),the severity of IS in the highest quartile SAA level group was about 2.13 folds of that in the lowest quartile group(OR=2.13,95%CI 1.34-3.69,P=0.043).Conclusions SAA is a novel inflammatory marker,which can predict IS happening and its severity.