【摘要】：背景:動(dòng)脈粥樣硬化斑塊的不穩(wěn)定性和卒中的發(fā)生相關(guān),微栓子信號(hào)是斑塊不穩(wěn)定的標(biāo)志,我們已經(jīng)確定血漿骨保護(hù)素(Osteoprotegerin,OPG)水平和卒中的發(fā)生相關(guān),因此我們探討血漿OPG水平在大動(dòng)脈粥樣硬化(large artery atherosclerosis,LAA)型腦梗死患者中是否與微栓子信號(hào)發(fā)生有關(guān),同時(shí)進(jìn)一步探討血漿OPG能否作為評(píng)估入院時(shí)神經(jīng)功能缺損嚴(yán)重性及微栓子信號(hào)發(fā)生的生物學(xué)標(biāo)記物。方法:按照TOAST分型選取我院前循環(huán)大動(dòng)脈粥樣硬化型腦梗死患者127例和同期健康對(duì)照56例作為研究對(duì)象。對(duì)LAA型腦梗死患者于發(fā)病72小時(shí)內(nèi)行經(jīng)顱多普勒超聲(transcranial Doppler sonography,TCD)監(jiān)測(cè)病變側(cè)微栓子,監(jiān)測(cè)時(shí)間為1小時(shí)。根據(jù)監(jiān)測(cè)結(jié)果,將LAA型腦梗死患者進(jìn)一步分為微栓子陽(yáng)性組和微栓子陰性組。同時(shí)記錄患者入院時(shí)NIHSS(National Institutes of Health Stroke Scale)評(píng)分。根據(jù)NIHSS評(píng)分,將卒中患者進(jìn)一步分為NIHSS Score≥6和NIHSS Score6組。采用酶聯(lián)免疫吸附測(cè)定法(ELISA)分別檢測(cè)所有研究對(duì)象血漿OPG水平,兩組之間進(jìn)行比較。結(jié)果:研究發(fā)現(xiàn)血漿OPG水平LAA型腦梗死患者明顯高于健康對(duì)照組(1944.03±604.76 vs 1371.17±467.99pg/ml,p0.001),NIHSS Score≥6高于NIHSS Score6組(2260.11±658.21 vs 1841.96±552.39 pg/ml,p=0.001,),微栓子陽(yáng)性組高于微栓子陰性組(2357.13±513.24 vs 1804.88±570.70pg/ml,p0.001)。用受試者曲線(ROC)分析血漿OPG預(yù)測(cè)神經(jīng)功能缺損嚴(yán)重性的可行性,ROC曲線下面積是0.734,臨界值是1998.44 pg/ml,敏感度80.6%,特異度65.6%。如果用血漿OPG的水平區(qū)分微栓子信號(hào)的發(fā)生,ROC曲線下面積0.766,臨界值2107.91pg/ml,敏感度68.8%,特異度73.7%。結(jié)論:血漿OPG水平和卒中的嚴(yán)重性及微栓子信號(hào)的發(fā)生明顯相關(guān),血漿OPG也許能夠作為神經(jīng)功能缺損嚴(yán)重性及微栓子信號(hào)發(fā)生的一個(gè)生物學(xué)標(biāo)志物。
[Abstract]:Background: the instability of atherosclerotic plaques is associated with the occurrence of stroke. Microemboli signal is a marker of plaque instability. We have identified a correlation between plasma osteoprotegerin (Osteoprotegerin,OPG) levels and stroke. Therefore, we investigate whether plasma OPG levels are associated with microemboli signal in patients with large atherosclerotic (large artery atherosclerosis,LAA type cerebral infarction. At the same time, whether plasma OPG can be used as a biological marker for evaluating the severity of neurologic impairment and the occurrence of microemboli signal at admission. Methods: according to TOAST classification, 127 patients with anterior circulation atherosclerotic cerebral infarction and 56 healthy controls were selected. The microemboli were monitored by transcranial Doppler (transcranial Doppler sonography,TCD (TCD) within 72 hours after onset of LAA cerebral infarction, and the monitoring time was 1 hour. According to the monitoring results, the patients with LAA type cerebral infarction were further divided into microemboli positive group and microemboli negative group. At the same time, the NIHSS (National Institutes of Health Stroke Scale) score on admission was recorded. According to NIHSS score, stroke patients were further divided into NIHSS Score 鈮，

本文編號(hào)：2257869