【摘要】：目的探討急性腦梗死(ACI)患者不同時(shí)期Apelin-13和應(yīng)激相關(guān)蛋白熱休克蛋白70(HSP-70)、β內(nèi)啡肽(β-EP)水平的變化及其與預(yù)后的相關(guān)性。方法選取2013年1月—2014年12月在復(fù)旦大學(xué)附屬上海市第五人民醫(yī)院確診為ACI的患者50例作為ACI組,另選取同期在本院體檢正常者40例作為對(duì)照組。采集兩組受試者血液,并檢測(cè)對(duì)照組和ACI組發(fā)病第1、3、7、14、21、30天Apelin-13、HSP-70、β-EP水平。ACI患者根據(jù)改良Rankin分級(jí)法評(píng)估預(yù)后,分為預(yù)后好(n=28)、一般(n=15)、差(n=7),并比較不同預(yù)后患者發(fā)病第1天的Apelin-13、HSP-70、β-EP水平、格拉斯哥昏迷量表(GCS)評(píng)分、急性生理學(xué)與慢性健康狀況評(píng)分系統(tǒng)Ⅱ(APACHEⅡ)評(píng)分、美國(guó)國(guó)立衛(wèi)生研究所卒中量表(NHISS)評(píng)分、洼田飲水試驗(yàn)分級(jí)。結(jié)果對(duì)照組、ACI組不同時(shí)期Apelin-13、HSP-70水平比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),β-EP水平比較差異無統(tǒng)計(jì)學(xué)意義(P0.05);其中ACI組第1天Apelin-13水平低于對(duì)照組,ACI組第14、21、30天Apelin-13水平高于ACI組第1天(P0.05);ACI組第1、3天HSP-70水平高于對(duì)照組,ACI組第3、7、14、21、30天HSP-70水平低于ACI組第1天(P0.05)。ACI患者Apelin-13與HSP-70呈直線負(fù)相關(guān)(r=-0.909,P=0.012),Apelin-13與β-EP無直線相關(guān)性(r=-0.172,P=0.744),HSP-70與β-EP無直線相關(guān)性(r=0.121,P=0.820)。不同預(yù)后ACI患者β-EP水平比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);不同預(yù)后ACI患者Apelin-13、HSP-70水平、GCS評(píng)分、APACHEⅡ評(píng)分、NHISS評(píng)分、洼田飲水試驗(yàn)分級(jí)比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);其中預(yù)后差者Apelin-13水平、GCS評(píng)分均低于預(yù)后好和預(yù)后一般者,HSP-70水平、APACHEⅡ評(píng)分、NHISS評(píng)分、洼田飲水試驗(yàn)分級(jí)高于預(yù)后好和預(yù)后一般者(P0.05);預(yù)后一般者GCS評(píng)分低于預(yù)后好者,APACHEⅡ評(píng)分、NHISS評(píng)分、洼田飲水試驗(yàn)分級(jí)高于預(yù)后好者(P0.05)。結(jié)論Apelin-13水平在ACI發(fā)病第1天降低,隨ACI病程逐漸升高;HSP-70水平在ACI發(fā)病第1天升高,隨ACI病程逐漸下降。預(yù)后差的ACI患者發(fā)病第1天的Apelin-13水平、GCS評(píng)分低于預(yù)后一般和預(yù)后好者,而HSP-70水平、APACHEⅡ評(píng)分、NHISS評(píng)分、洼田飲水試驗(yàn)分級(jí)高于預(yù)后一般和預(yù)后好者,可以根據(jù)這些指標(biāo)的變化判斷ACI患者預(yù)后。
[Abstract]:Objective to investigate the changes of Apelin-13, stress-related heat shock protein 70 (HSP-70) and 尾 -endorphin (尾 -EP) in patients with acute cerebral infarction (ACI) at different stages and their correlation with prognosis. Methods from January 2013 to December 2014, 50 patients with ACI diagnosed in Shanghai Fifth people's Hospital affiliated to Fudan University were selected as ACI group, and 40 normal subjects were selected as control group. The blood samples of two groups were collected, and the levels of Apelin-13,HSP-70, 尾-EP were measured on the 30th day after the onset of the disease in the control group and the ACI group. The prognosis of the patients with ACI was evaluated according to the modified Rankin grading method. The prognosis was divided into three groups: good prognosis (n = 28), average (n = 15) and poor (n = 7). The level of Apelin-13,HSP-70, 尾 -EP in patients with different prognosis was compared on the first day of onset. Glasgow coma scale (Glasgow coma scale), Acute Physiology and chronic Health scoring system 鈪，

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