【摘要】：目的:本文旨在探討血清維生素D濃度與微栓子信號(hào)檢測(cè)的相關(guān)性,并進(jìn)一步探討前者與大動(dòng)脈粥樣硬化型腦梗死患者預(yù)后的關(guān)系。方法:納入103例頸內(nèi)動(dòng)脈(internal carotid artery ICA)或大腦中動(dòng)脈(middle cerebral artery MCA)供血區(qū)的動(dòng)脈粥樣硬化性腦梗死(1arge artery atheroscleros LAA)急性期的患者(LAA組),58例同期健康體檢人群為對(duì)照組。應(yīng)用ELISA法檢測(cè)所有受試者維生素D(Vitamin D)濃度,兩組之間進(jìn)行維生素D濃度比較并采用二元Logistic相關(guān)回歸分析LAA腦卒中患者的危險(xiǎn)因素;將LAA組患者根據(jù)微栓子(microembolic signals MES)檢測(cè)結(jié)果,分為微栓子陽(yáng)性組MES(+)(29例)與微栓子陰性組MES(-)(74例),分析維生素D濃度與微栓子結(jié)果的相關(guān)性,并應(yīng)用受試者工作特征(ROC)曲線(xiàn)評(píng)估維生素D濃度區(qū)分微栓子陽(yáng)性的價(jià)值;對(duì)LAA組患者隨訪3個(gè)月,結(jié)合改良Ranking量表(m RS)評(píng)分,分為預(yù)后良好組(m RS評(píng)分3分)及預(yù)后不良組(m RS評(píng)分≥3分),比較兩組維生素D濃度,并ROC曲線(xiàn)評(píng)估維生素D濃度對(duì)LAA型腦卒中患者預(yù)后的預(yù)測(cè)價(jià)值。結(jié)果:腦梗死患者血清維生素D水平(19.47±16.78)ng/ml明顯低于對(duì)照組(38.00±25.02)ng/ml,差異有統(tǒng)計(jì)學(xué)意義(P0.01),二元Logistic回歸分析維生素D(OR=0.960,95%CI:0.940-0.980)是大動(dòng)脈粥樣硬化性腦卒中的獨(dú)立保護(hù)因素。MES陽(yáng)性患者的血清維生素D水平(10.90±6.50)ng/m L低于MES陰性組(22.83±18.34)ng/m L,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。預(yù)后不良組維生素D濃度顯著低于預(yù)后良好組(12.37±8.22VS27.00±20.04)差異有統(tǒng)計(jì)學(xué)意義(P0.01)。應(yīng)用維生素D濃度水平區(qū)分大動(dòng)脈粥樣硬化患者中微栓子陽(yáng)性與微栓子陰性,ROC曲線(xiàn)下面積0.757,MES陽(yáng)性與MES陰性最佳臨界值為13.99ng/m L,靈敏度及特異度分別為73.0%,72.4%。同時(shí)應(yīng)用維生素D評(píng)估LAA型腦梗死患者預(yù)后,其ROC曲線(xiàn)面積為0.797,最佳診斷臨界值17.97ng/m L(靈敏度64.0%,特異度88.7%)。結(jié)論:LAA型患者較健康對(duì)照組人群血清維生素D濃度降低。MES(+)組較MES(-)組維生素D濃度顯著降低。維生素D濃度在LAA型腦卒中預(yù)后不良組中較預(yù)后良好組顯著降低。維生素D可以作為提示LAA型腦卒中微栓子存在及預(yù)測(cè)預(yù)后不良的血漿指標(biāo)。
[Abstract]:Objective: to investigate the relationship between serum vitamin D concentration and microemboli signal detection, and the relationship between the former and the prognosis of patients with atherosclerotic cerebral infarction. Methods: a total of 58 healthy controls were enrolled in the acute stage of acute cerebral infarction (LAA group) in patients with acute cerebral infarction (LAA group) in the (internal carotid artery of internal carotid artery (ICA) or (middle cerebral artery MCA of middle cerebral artery (MCA). The concentration of vitamin D in all subjects was detected by Elisa, and the risk factors of stroke patients in LAA patients were analyzed by binary Logistic correlation regression analysis, and the results of microemboli (microembolic signals mes were used to detect the risk factors of stroke patients in LAA group. There were 29 cases of mes () (in positive microemboli group and 74 cases of mes (-) in microembolus negative group. The correlation between vitamin D concentration and the results of microemboli was analyzed, and the value of vitamin D concentration in differentiating microemboli positive was evaluated by the operating characteristic curve of subjects (ROC). The patients in LAA group were followed up for 3 months. The patients were divided into good prognosis group (Mrs score 3 points) and poor prognosis group (Mrs score 鈮，

本文編號(hào)：2130732