血清血管生成素1水平与急性脑梗死严重程度的相关性

目的 探讨患者血清血管生成素1(Ang-1)水平与急性脑梗死的严重程度的相关性,为临床早期病情评估提供依据.方法 收集西安市第九医院诊断为急性脑梗死的患者为病例组,同时收集本院同期体检中心的健康体检者为对照组.收集所有研究对象的一般临床资料,并测定血清Ang-1水平.病例组分别根据美国国立卫生研究院脑卒中量表(NIHSS)评分及MRI最大梗死直径分组.比较病例组与对照组一般临床资料的差异.采用Logistic回归分析病例组的发病危险因素.通过ROC曲线评估血清Ang-1水平的诊断价值.采用Spearman相关分析脑梗死严重程度与Ang-1的相关性.结果 病例组患者的吸烟史、高血压病史、糖尿病史及心房纤颤病史的比例高于对照组,而血清Ang-1水平低于对照组,差异有统计学意义(P<0.05).Logistic回归分析显示,糖尿病史及血清Ang-1水平是急性脑梗死的危险因素(P<0.05).ROC曲线分析显示血清Ang-1水平在诊断急性脑梗死患者时的曲线下面积为0.791(95%CI=0.751~0.830).NIHSS评分为轻度、中度及重度组患者的血清Ang-1水平分别为(1.65±0.22)ng/ml,(1.45±0.24)ng/ml和(1.26±0.27)ng/ml,差异有统计学意义(F=47.940,P<0.01).MRI显示大梗死、中梗死及小梗死组患者的血清Ang-1水平分别为(1.38±0.23)ng/ml,(1.49±0.30)ng/ml和(1.71±0.23)ng/ml,差异有统计学意义(F=40.911,P<0.01).Spearman相关性分析显示急性脑梗死患者入院时NIHSS评分及MRI梗死最大直径与血清Ang-1水平均呈负相关(r=-0.498,-0.459;P<0.01).结论 脑梗死患者的血清Ang-1水平下降,并与脑梗死的严重程度密切相关.

Correlation between levels of serum angiopoietin-1 and severity of acute cerebral infarction

Objective To investigate the correlation between levels of serum angiopoietin-1(Ang-1) and the severity of acute cerebral infarction, in order to provide evidences for early clinical evaluation of acute cerebral infarction.Methods Patients with acute cerebral infarction in the Ninth Hospital of Xi'an City were enrolled as the case group. In the corresponding period, healthy subjects in physical examination cen-ter were enrolled as the control group. The general clinical data of all subjects were collected. The levels of serum Ang-1 were measured in all subjects. The patients were divided into three groups according to NIHSS score or maximum infarct diameter in MRI respectively. The difference of clinical data between the case group and con-trol group were analysed. Logistic regression analysis was used to analyse the risk factors. ROC curve analysis was used to evaluate the diagnostic value of serum Ang-1. Spearman correlation analysis was used to analyze the correlation.Results The percentages of smoking, hypertension, diabetes mellitus and atrial fibrillation were significantly increased in the case group, while the levels of serum Ang-1 were significantly decreased (P<0.05). Logistic regression analysis showed that diabetes mellitus and the levels of serum Ang-1 were risk factors of cerebral infarction(P<0.05). ROC curve analysis showed that the area under the ROC curve was 0.791 (95%CI=0.751-0.830) about the diagnosis of acute cerebral infarction with the level of serum Ang-1. Significant differences were found between the levels of serum Ang-1 in mild, moderate and severe NIHSS group(P<0.01). Significant differences were found between the levels of serum Ang-1 in large infarction, middle infarction and small infarction group(P<0.01). Spearman correlation analysis showed that NIHSS score and maximal diameter of infarction in MRI were negatively correlated with the serum level of Ang-1(r= -0.498, -0.459;P<0.01) in acute cerebral infarction patients.Conclusions The level of serum Ang-1 in patients with acute cerebral in-farction decreases, which is closely related to the severity of cerebral infarction.