急性脑梗死患者血清YKL-40检测的临床意义

目的通过检测急性脑梗死患者发病后48h内血清YKL-40的表达量,探讨其与牛津郡社区卒中项目（OCSP）分型及梗死面积大小的关系,以指导临床诊治。方法对54例急性脑梗死患者和20例正常对照者进行血清YKL-40的检测,然后分析其与病情程度及临床分型的关系。结果急性脑梗死患者血清YKL-40浓度中位数为158.47ng/ml（IR：182.40）,正常对照组为50.50ng/ml（IR：34.85）,两组比较差异有统计学意义（P〈0.001）;OCSP各亚型YKL-40升高幅度不同,完全前循环梗死（TACI）型表达量明显高于其他亚型（P〈0.01）;YKL-40在大梗死型的含量显著高于其他亚型（P〈0.02）。结论脑梗死后血清YKL-40水平升高,与病灶大小相关,在不同OCSP分型之间表达量不同,血清YKL-40可能成为指导脑梗死临床分型及评估病情程度的新的生物学指标。

Clinical significance of serum YKL-40 determination in patients with acute cerebral infarction

Objective To study the alteration and clinical significance of serum YKL-40 within the first 48 hours from onset in patients with acute cerebral infarction. Methods Serum YKL-40 levels were measured by enzyme immunoassay in 54 patients with acute cerebral infarction and 20 healthy controls. The relationship among the YKL-40 and clinical classifications and the severity of stroke were investigated. Results The levels of serum YKL-40 were significantly elevated in patients with cerebral infarction than that in the normal control subjects（P0.001）.The levels of serum YKL-40 in TACI group and large infarct group were significantly higher than those in other groups（P0.01,P0.02）. Conclusions Serum YKL-40 level increased after ischemic stroke and was related to infarct size. The concentrations were different in subtypes of OCSP classifications. The serum YKL-40 might be a new biological marker to predict the severity and prognosis of ischemic stroke.