急性脑梗死患者血浆生物学指标与TOAST分型的关系

目的:探讨急性脑梗死患者血浆高敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)及低密度脂蛋白(LDL)水平与急性卒中治疗Org10172试验分型(Trial of org 10172 in acute stroke treatment classification,TOAST)的关系,为脑梗死临床预防和治疗提供依据。方法:检测218例急性脑梗死患者血浆hs-CRP、Hcy及LDL水平,应用NIHSS量表对患者评分,分析TOAST各亚型与上述指标的关系。对照组60例为同期科室住院的其他非脑血管疾病患者。结果:TOAST分型中LAA型患者Hcy水平显著高于其他4个亚组(P<0.01);LAA型和CE型患者hs-CRP水平及NIHSS评分与其他组比较差异有统计学意义(P<0.05);LAA型与SAO型患者与对照组比较LDL水平差异有统计学意义(P<0.05),各亚型之间比较LDL水平无显著性差异。结论:急性脑梗死患者血浆hs-CRP、Hcy及LDL水平在TOAST各亚型中具有差异,可以为脑梗死患者病因学分型及个体化治疗提供依据。

The Relationship between Plasma Biological Markers and Subtypes of TOAST in Patients with Acute Cerebral Infarction

Objective To explore the relationship between the levels of plasma high sensitive C reactive protein(hs-CRP),homocysteine(Hcy) and low density lipoprotein(LDL) with the subtypes of TOAST in patients with acute cerebral infarction,to provide basis for clinical prevention and treatment.Methods The plasma levels of hs-CRP,Hcy and LDL in 218 patients with acute cerebral infarction were determined,and the nerve function was scored by using NIHSS scale.The relationship between each subtypes of TOAST and above-mentioned indexes were analyzed.The 60 cases of control group were hospitalization patients excluding cerebrovascular disease.Results In the subtypes of TOAST,the level of Hcy in patients of LAA type was significantly higher than those in other four subtype groups(P<0.01);the hs-CRP levels and NIHSS scores in patients of LAA type were significantly different from the other four subtype groups(P<0.05);the LDL levels in patients of type LAA and type SAO were significantly different,while it had no significant difference during the other three subtypes.Conclusion There are significant differences of the levels of plasma hs-CRP,Hcy and LDL during each subtypes of TOAST in patients with acute cerebral infarction,and these plasma biological markers could provide basis for etiological typing and personalized treatment.