發(fā)布時(shí)間：2018-01-13 12:35

  本文關(guān)鍵詞：ABCD~2評(píng)分聯(lián)合高敏C-反應(yīng)蛋白、胎盤(pán)生長(zhǎng)因子、單核細(xì)胞趨化因子-1預(yù)測(cè)短暫性腦缺血發(fā)作后短期發(fā)生腦梗死的風(fēng)險(xiǎn)　出處：《河北醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 短暫性腦缺血發(fā)作 腦梗死 高敏-C反應(yīng)蛋白 胎盤(pán)生長(zhǎng)因子 單核細(xì)胞趨化因子-1 ABCD2評(píng)分 預(yù)測(cè)

【摘要】：目的:通過(guò)ABCD2評(píng)分聯(lián)合高敏C-反應(yīng)蛋白、胎盤(pán)生長(zhǎng)因子、單核細(xì)胞趨化因子-1在短暫性腦缺血發(fā)作初期的濃度水平探討對(duì)短暫性腦缺血發(fā)作(Transient Ischemic Attack,TIA)后7d內(nèi)發(fā)生腦梗死(Cerebral Infarction,CI)的預(yù)測(cè)價(jià)值。方法:2014年1月-2015年1月在邯鄲市285醫(yī)院診斷為T(mén)IA的符合標(biāo)準(zhǔn)的住院患者90例,根據(jù)患者發(fā)病后是否發(fā)生CI分為兩組,CI組22例和非CI組68例,統(tǒng)計(jì)所有患者的常見(jiàn)腦血管疾病危險(xiǎn)因素、高敏C-反應(yīng)蛋白(hypersensitive C-reactive protein,hs-CRP)、胎盤(pán)生長(zhǎng)因子(placenta growth factor,Pl GF)及單核細(xì)胞趨化因子-1(monocyte chemottractant protein-1,MCP-1)濃度水平,并進(jìn)行ABCD2評(píng)分。應(yīng)用單因素分析法比較CI組和非CI組間腦血管疾病常見(jiàn)危險(xiǎn)因素、hs-CRP、Pl GF、MCP-1水平及ABCD2評(píng)分的差異性。然后進(jìn)一步將所有患者以hs-CRP≤3mg/L、Pl GF≤20 pg/ml、MCP-1≤245pg/ml和hs-CRP3mg/L、Pl GF20 pg/ml、MCP-1245pg/ml為界進(jìn)行分層,再根據(jù)ABCD2評(píng)分≤3分和3分分為兩組,以hs-CRP≤3mg/L、Pl GF≤20 pg/ml、MCP-1≤245pg/ml且ABCD2評(píng)分≤3分組患者為基線組,其余各組分別與基線組比較,利用Logistic回歸的分析方法來(lái)評(píng)價(jià)TIA后短期內(nèi)發(fā)展為CI的發(fā)生風(fēng)險(xiǎn)。結(jié)果:(1)基線資料單因素分析:CI組平均年齡(65.20±8.6)歲、hs-CRP(6.10±3.51)mg/L、MCP-1(456.60±83.35)pg/ml、Pl GF(25.61±4.77)pg/ml、ABCD2評(píng)分(4.68±1.24)均高于非CI組[分別為(61.10±7.6)歲、(3.65±3.52)mg/L、(248.58±58.38)pg/ml、(20.70±4.83)pg/ml、(3.52±1.49)分],兩組差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)Logistic回歸結(jié)果:hs-CRP3mg/L、MCP-1245pg/ml、Pl GF20pg/ml聯(lián)合ABCD2評(píng)分3分組近期進(jìn)展為腦梗死的風(fēng)險(xiǎn)是基線組的10.749倍(95%CI為3.419-34.283,P0.05),校正年齡、性別、高血壓、糖尿病、家族卒中史和吸煙史后,其TIA患者短期發(fā)生腦梗死的危險(xiǎn)性升至13.451倍(95%CI為3.221-56.753,P0.05)。結(jié)論:ABCD2評(píng)分是預(yù)測(cè)TIA后短期內(nèi)發(fā)生CI的一種簡(jiǎn)單、有效的工具之一,將高敏-C反應(yīng)蛋白、胎盤(pán)生長(zhǎng)因子、單核細(xì)胞趨化因子-1與ABCD2評(píng)分聯(lián)合能提高對(duì)CI的預(yù)測(cè)價(jià)值。
[Abstract]:Objective: to combine Gao Min C-reactive protein with ABCD2 score and placental growth factor. The concentration of monocyte chemokine 1 in the early stage of transient ischemic attack; to investigate the effect of monocyte chemokine 1 on transient Ischemic Attack in transient ischemic attack. Cerebral Infarction occurred within 7 days after TIA. Methods: from January 2014 to January 2015, 90 inpatients with TIA were diagnosed as TIA. According to whether CI occurred or not, the patients were divided into two groups: 22 cases in CI group and 68 cases in non-CI group. The risk factors of common cerebrovascular diseases in all patients were analyzed. Hypersensitive C-reactive protein (hs-CRP). Placenta growth factor. Pl GF) and monocyte chemokine-1 chemottractant protein-1 (MCP-1). The common risk factors of cerebrovascular disease between CI group and non-CI group were compared by univariate analysis. The difference of MCP-1 level and ABCD2 score. Then all patients were further treated with hs-CRP 鈮，

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