本文選題：脂肪細(xì)胞型脂肪酸結(jié)合蛋白 + 腦梗死　； 參考：《山西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：通過(guò)比較腦梗死組與非腦梗死組以及頸動(dòng)脈無(wú)斑塊組、穩(wěn)定斑塊組、不穩(wěn)定斑塊組組間血清脂肪細(xì)胞型脂肪酸結(jié)合蛋白(A-FABP)水平,探討血清A-FABP水平與腦梗死的發(fā)生、頸動(dòng)脈粥樣硬化斑塊的形成及不穩(wěn)定性的關(guān)系,評(píng)價(jià)A-FABP作為腦梗死、頸動(dòng)脈粥樣硬化斑塊形成及斑塊不穩(wěn)定的臨床預(yù)測(cè)因素的價(jià)值。 方法：根據(jù)入選標(biāo)準(zhǔn)選取急性腦梗死患者67例(腦梗死組),對(duì)照組31例(非腦梗死者),所有受試者通過(guò)頸動(dòng)脈彩色多普勒超聲檢查測(cè)定頸動(dòng)脈內(nèi)中膜厚度(IMT)并觀察頸動(dòng)脈粥樣硬化斑塊的數(shù)目及回聲情況。根據(jù)有無(wú)斑塊及斑塊的性質(zhì)將腦梗死組分為無(wú)斑塊組、穩(wěn)定斑塊組、不穩(wěn)定斑塊組。所有受試者均抽取空腹肘靜脈血,檢測(cè)血清A-FABP、TC、 TG、LDL-C、HDL-C、FPG水平。 結(jié)果：1.腦梗死與對(duì)照組比較顯示：?jiǎn)我蛩胤治觯貉錋-FABP(t=6.224)與高血壓病構(gòu)成比(χ2=26.624)、糖尿病構(gòu)成比(χ2=19.817)、血清TG(t=3.432)水平、血清TC(t=2.230)水平、血清LDL-C(t=4.372)水平、血清HDL-C(t=-5.496)水平、頸動(dòng)脈斑塊檢出率(χ2=34.765)、頸動(dòng)脈斑塊檢出率(χ2=28.441)一樣都與腦梗死有關(guān),差異性均有統(tǒng)計(jì)學(xué)意義(P0.05)；多變量logistic逐步回歸分析：血清A-FABP水平(OR=3.165),血清LDL-C水平(OR=5.756,血清HDL-C水平(OR=0.249),高血壓病(OR=6.403),糖尿病(OR=34.878),P值均0.05。 2.無(wú)斑塊組、穩(wěn)定斑塊組、不穩(wěn)定斑塊組比較顯示：血清A-FABP(t=6.467)與高血壓病構(gòu)成比(χ2=6.586)、糖尿病構(gòu)成比(χ2=6.296)、血清TG(t=3.385)水平、血清TC(t=3.336)水平、血清LDL-C(t=4.917)水平、血清HDL-C(t=6.540)水平與頸動(dòng)脈粥樣硬化斑塊形成及不穩(wěn)定性有關(guān),差異均有統(tǒng)計(jì)學(xué)意義(P0.05)；多變量logistic逐步回歸分析：血清4-FABP水平(OR=2.147),血清LDL-C水平(OR=4.267),血清HDL-C水平(OR=0.160),高血壓病(OR=5.590),糖尿病(OR=6.469),P值均0.05。 3.血清A-FABP水平與TG、TC、HDL-C、LDL-C、FPG進(jìn)行相關(guān)分析顯示：血清A-FABP水平與TG(r=0.472)、TC(r=0.331)、LDL-C(r=0.502)呈正相關(guān),與HDL-Cr=-0.537)呈負(fù)相關(guān)；偏相關(guān)分析示：血清A-FABP水平與TG(r=0.209)、LDL-C(r=0.380)呈正相關(guān),與HDL-C(r=-0.481)呈負(fù)相關(guān),P0.05。 結(jié)論：1.血清A-FABP水平與血脂代謝、頸動(dòng)脈粥樣硬化斑塊形成及斑塊的不穩(wěn)定性有關(guān),從而與腦梗死的發(fā)生相關(guān)。 2.血清A-FABP增高可能是腦梗死及頸動(dòng)脈粥樣硬化形成的危險(xiǎn)因素。 3.血清A-FABP可能是腦梗死、頸動(dòng)脈粥樣硬化斑塊形成及斑塊不穩(wěn)定的臨床預(yù)測(cè)因素。
[Abstract]:Objective: to compare the serum levels of adipocyte fatty acid binding protein (FFABP) between cerebral infarction group and non-cerebral infarction group, carotid artery without plaque group, stable plaque group and unstable plaque group, and to explore the relationship between serum A-FABP level and cerebral infarction. To evaluate the value of A-FABP as a clinical predictor of cerebral infarction, carotid atherosclerotic plaque formation and plaque instability. Methods: according to the inclusion criteria, 67 patients with acute cerebral infarction (cerebral infarction group) and 31 control group (non-cerebral infarction patients) were selected and observed by carotid artery color Doppler ultrasonography for carotid intima media thickness (IMT). The number and echo of carotid atherosclerotic plaques were examined. According to the plaque and the character of plaque, the cerebral infarction group was divided into three groups: no plaque group, stable plaque group and unstable plaque group. All subjects were collected from fasting cubital vein blood to detect the levels of serum A-FABPnTC, TGD-LDL-C+ HDL-CfPG. The result is 1: 1. Compared with the control group, single factor analysis showed that the ratio of serum A-FABPtU 6.224) to hypertension (蠂 2 + 26.624), diabetes mellitus (蠂 2 + 19.817), serum TGN (3.43 2), serum TCU (2.230), serum LDL-Ctn (4.372), serum HDL-CntU (-5.496). The detection rate of carotid plaques (蠂 ~ 2 ~ 2 ~ (34.765)) and carotid plaques (蠂 ~ (2) ~ (2) ~ (28) 441) were all related to cerebral infarction. Multivariate logistic stepwise regression analysis showed that the serum A-FABP level was 3.165%, the serum LDL-C level was 5.756, the serum HDL-C level was 0.249%, the hypertension was 6.403%, the diabetes mellitus was 34.878 P value. 2. The results showed that the ratio of serum A-FABPtX 6.467 to hypertension, diabetes mellitus (蠂 2) 6.296%, serum TGN 3.336%, serum TCU ~ (3 36) and LDL-C ~ (2 +) 4.917 were higher than those in control group (蠂 ~ 2 = 6.296), stable plaque group and unstable plaque group (P < 0.05), compared with those in non-plaque group (P < 0.05), stable plaque group and unstable plaque group (P < 0.05), compared with those of hypertension (蠂 ~ 2 = 6.586). The multivariate logistic stepwise regression analysis showed that the serum 4-FABP level was 2.147%, the serum LDL-C level was 4.267%, the serum HDL-C level was 0.160%, the hypertension OR5.590%, the diabetes 6.469m P 0.050.The serum HDL-ct level was related to the formation and instability of carotid atherosclerotic plaques (P < 0.05), and the multivariate logistic stepwise regression analysis showed that the serum 4-FABP level was 2.147%, the serum LDL-C level was 4.267%, the serum HDL-C level was 0.160, the hypertension OR5.590%, and the DM 6.469m P values were 0.05. 3. The correlation analysis between serum A-FABP level and A-FABP level showed that the level of serum A-FABP was positively correlated with TGR 0.472 and negatively correlated with HDL-Cr-0.537), and the level of serum A-FABP was positively correlated with TGR 0.209 LDL-Cnr 0.380, and negatively correlated with HDL-Cr-0.481LDL-Cr-0.537), and negatively correlated with HDL-Cr-0.481 (P 0.05). Conclusion 1. Serum A-FABP level was related to lipid metabolism, carotid atherosclerotic plaque formation and plaque instability, which was related to the occurrence of cerebral infarction. 2. Elevated serum A-FABP may be a risk factor for cerebral infarction and carotid atherosclerosis. 3. Serum A-FABP may be a clinical predictor of cerebral infarction, carotid atherosclerotic plaque formation and plaque instability.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R743.3

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