脑梗死患者血清白蛋白、球蛋白水平及其比值变化研究

目的 探讨脑梗死患者血清白蛋白、球蛋白水平及其比值变化及对预后的影响.方法 选择自2006年6月至2010年6月于兴义市人民医院神经内科住院治疗的120例急性脑梗死患者为研究对象Ⅰ组,选择同期具有脑血管病风险因素且与Ⅰ组危险因素匹配的110例个体为研究对象Ⅱ组,选择同期体检健康的90例志愿者为研究对象Ⅲ组.比较3组对象血清白蛋白、球蛋白、白蛋白/球蛋白比值、纤维蛋白原、外周血细胞的差异.随访2年后比较3组对象中白蛋白/球蛋白比值≥1.45及白蛋白/球蛋白比值＜1.45个体的预后差异. 结果 Ⅲ组、Ⅱ组及Ⅰ组血清球蛋白、纤维蛋白原、白细胞水平依次升高,组间比较差异有统计学意义(P＜0.05)；Ⅲ组、Ⅱ组及Ⅰ组血清白蛋白水平、白蛋白/球蛋白比值依次降低,组间比较差异有统计学意义(P＜0.05).随访2年后Ⅰ组、Ⅱ组、Ⅲ组再发脑血管病发生率分别为24.1％、18.5％及2.3％,组间比较差异有统计学意义(P＜0.05).Ⅰ、Ⅱ组白蛋白/球蛋白比值＜1.45亚组患者发生脑血管病事件风险是白蛋白/球蛋白比值≥1.45亚组患者的3.6倍. 结论 血清白蛋白、球蛋白水平及白蛋白/球蛋白比值与脑梗死发生密切相关,脑梗死及脑血管病危险人群白蛋白/球蛋白比值降低者较白蛋白/球蛋白比值正常者发生脑血管病事件风险增加.

Changes of serum albumin and globulin levels and albumin-globulin ratio in patients with cerebral infarction

Objective To explore the changes of serum albumin and globulin levels andalbumin-globulin ratio in patients with cerebral infarction,and their prognostic value.Methods Onehundred and twenty patients with acute ischemic stroke,admitted to our hospital from June 2006 to June2010,were chosen as Group Ⅰ; Group Ⅱ included 110 subjects matched with Group Ⅰ for age,medications,and clinical risk factors of stroke; and Group Ⅲ was composed of 90 healthy volunteers,matched for agewith Group Ⅰ and Ⅱ.Serum albumin and globulin levels,albumin-globulin ratio,fibrinogen level andnumber of peripheral blood cells in the 3 groups were compared; and the prognosis of subjects with analbumin-globulin ratio above 1.45 or less were compared between each 2 groups after 2-year-follow-up.Results Serum globulin,fibrinogen and leucocyte levels in Group Ⅰ were significantly higher than thosein Group Ⅱ and Ⅲ,and those in Group Ⅱ were obviously higher than those in Group Ⅲ (P＜0.05).Serumalbumin level and albumin-globulin ratio in Group Ⅰ were significantly lower than those in Group ⅡⅡ andⅢ,and those in Group Ⅱ were obviously lower than those in Group Ⅲ (P＜0.05).To the end of follow-up,the incidence of recurrent cerebrovascular disease were 24.1％,18.5％ and 2.3％ in Group Ⅰ,Ⅱ and Ⅲ,respectively(P＜0.05).Subjects with albumin-globulin ratio less than 1.45 in Group Ⅰ and Ⅱ had 3.6 timesof risk for a subsequent vascular event as compared with their counterparts with albumin-globulin ratioabove 1.45.Conclusion Serum albumin and globulin levels and albumin-globulin ratio have a closecorrelation with cerebral infarction.The patients with low albumin-globulin ratio have increased risk ofcerebrovascular disease as compared with subjects of normal albumin-globulin ratio in subjects with cerebral infarction and high-risk cerebrovascular disease.