本文選題：PCSK9　切入點(diǎn)：動(dòng)脈粥樣硬化　出處：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:探討在動(dòng)脈粥樣硬化性腦梗死患者中血清PCSK9水平與腦動(dòng)脈粥樣硬化程度及多項(xiàng)動(dòng)脈粥樣硬化危險(xiǎn)因素的關(guān)系,并探討血清PCSK9水平與口服他汀類藥物降脂效果的關(guān)系。方法:選取于2015年12月至2016年12月期間在吉林大學(xué)第一醫(yī)院行CA和TCD的神經(jīng)內(nèi)科動(dòng)脈粥樣硬化性腦梗死患者為研究對(duì)象,收集其空腹血標(biāo)本,記錄患者一般臨床資料,包括年齡、性別、高血壓病史、糖尿病史、高血脂病史、既往服藥史、吸煙史、飲酒史、家族史,及常規(guī)血清生化指標(biāo)如血脂、空腹血糖、葉酸、維生素B12、尿酸、同型半胱氨酸等。記錄患者CA、TCD資料,根據(jù)AS病變程度分組,具體分為無斑塊組、斑塊組(CA頸動(dòng)脈斑塊形成,但血管未見狹窄)、輕度狹窄組(狹窄率50%)、中度狹窄組(狹窄率50%~69%)、重度狹窄(狹窄率70%~99%)或閉塞組(CA及TCD均未探及相關(guān)血管的確切的血流信號(hào))。用ELISA方法檢測(cè)入組患者血清PCSK9的水平。對(duì)使用他汀類藥物降脂治療的患者,我們通過隨訪評(píng)估其他汀類藥物治療前后血脂代謝指標(biāo)的改變。利用統(tǒng)計(jì)學(xué)方法對(duì)血清PCSK9水平與腦動(dòng)脈粥樣硬化程度、動(dòng)脈粥樣硬化危險(xiǎn)因素、口服他汀類藥物降脂效果進(jìn)行相關(guān)性分析。結(jié)果:1.本研究中血清PCSK9水平中位數(shù)為130.76ng/ml,第25百分位數(shù)為105.71 ng/ml,第75百分位數(shù)為157.54 ng/ml。女性患者與男性血清PCSK9之間存在統(tǒng)計(jì)學(xué)差異(P0.05),女性PCSK9水平稍高。2.血清PCSK9水平和腦動(dòng)脈粥樣硬化程度呈正相關(guān),具有統(tǒng)計(jì)學(xué)意義(P0.01)。3.血清PCSK9水平與SBP、FBG、TG、LDL-C、TC呈正相關(guān),有統(tǒng)計(jì)學(xué)意義(P0.05)。以血清PCSK9水平為因變量,進(jìn)行多元回歸分析,結(jié)果提示血清PCSK9水平與TG、LDL-C、TC三種危險(xiǎn)因素關(guān)系更為密切。4.經(jīng)過短期(一個(gè)月)他汀治療,血清TC、TG、LDL-C均較治療前下降,HDL-C較治療前上升(P0.01)。血清PCSK9水平與各血脂組份的下降值無明顯相關(guān)性(P0.05)。結(jié)論:1.女性PCSK9水平高于男性。2.血清PCSK9水平與腦動(dòng)脈粥樣硬化程度及其多項(xiàng)危險(xiǎn)因素呈正相關(guān)。3.血清PCSK9水平與他汀降脂效果無明顯相關(guān)性。
[Abstract]:Objective: to investigate the relationship between serum PCSK9 level and degree of cerebral atherosclerosis and risk factors of atherosclerosis in patients with atherosclerotic cerebral infarction. To explore the relationship between serum PCSK9 level and the effect of oral statins on reducing blood lipid. Methods: the patients with atherosclerotic cerebral infarction (ACI) who were treated with CA and TCD in the first Hospital of Jilin University from December 2015 to December 2016 were selected as subjects. Fasting blood samples were collected and general clinical data were recorded, including age, sex, history of hypertension, history of diabetes, history of hyperlipidemia, history of medication, history of smoking, history of drinking alcohol, family history, and routine serum biochemical parameters such as blood lipid. Fasting blood glucose, folic acid, vitamin B12, uric acid, homocysteine and so on. However, no stenosis was found in mild stenosis group (stenosis rate 50%), moderate stenosis group (stenosis rate 50%), severe stenosis group (stenosis rate 7099%) or occlusion group, CA and TCD did not detect the exact blood flow signals of the related vessels. The level of serum PCSK9 in patients treated with statins. We were followed up to evaluate the changes of serum lipid metabolism before and after treatment with other statins. Serum PCSK9 levels and the degree of cerebral atherosclerosis, risk factors of atherosclerosis were measured by statistical methods. Results: 1.The median serum PCSK9 level in this study was 130.76 ng / ml, the 25th percentile was 105.71 ng / ml, and the 75th percentile was 157.54 ng / ml. The serum PCSK9 level was positively correlated with the degree of cerebral atherosclerosis. There was a positive correlation between serum PCSK9 level and serum PCSK9 level, and there was a significant correlation between serum PCSK9 level and LDL-CTC. The multivariate regression analysis was carried out with the serum PCSK9 level as a dependent variable. The results suggest that the serum PCSK9 level is more closely related to the three risk factors of TGG LDL-CfTC. The levels of serum TCU TGG LDL-C decreased and HDL-C increased compared with those before treatment. There was no significant correlation between serum PCSK9 level and the decrease of serum lipid components. Conclusion: 1. The level of PCSK9 in women is higher than that in men. 2. The level of serum PCSK9 and the degree of cerebral atherosclerosis and the degree of cerebral atherosclerosis. There was no significant correlation between serum PCSK9 level and statin effect.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.33

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