【摘要】：背景:動脈粥樣硬化斑塊的不穩(wěn)定性和卒中的發(fā)生相關,微栓子信號是斑塊不穩(wěn)定的標志,我們已經(jīng)確定血漿骨保護素(Osteoprotegerin,OPG)水平和卒中的發(fā)生相關,因此我們探討血漿OPG水平在大動脈粥樣硬化(large artery atherosclerosis,LAA)型腦梗死患者中是否與微栓子信號發(fā)生有關,同時進一步探討血漿OPG能否作為評估入院時神經(jīng)功能缺損嚴重性及微栓子信號發(fā)生的生物學標記物。方法:按照TOAST分型選取我院前循環(huán)大動脈粥樣硬化型腦梗死患者127例和同期健康對照56例作為研究對象。對LAA型腦梗死患者于發(fā)病72小時內行經(jīng)顱多普勒超聲(transcranial Doppler sonography,TCD)監(jiān)測病變側微栓子,監(jiān)測時間為1小時。根據(jù)監(jiān)測結果,將LAA型腦梗死患者進一步分為微栓子陽性組和微栓子陰性組。同時記錄患者入院時NIHSS(National Institutes of Health Stroke Scale)評分。根據(jù)NIHSS評分,將卒中患者進一步分為NIHSS Score≥6和NIHSS Score6組。采用酶聯(lián)免疫吸附測定法(ELISA)分別檢測所有研究對象血漿OPG水平,兩組之間進行比較。結果:研究發(fā)現(xiàn)血漿OPG水平LAA型腦梗死患者明顯高于健康對照組(1944.03±604.76 vs 1371.17±467.99pg/ml,p0.001),NIHSS Score≥6高于NIHSS Score6組(2260.11±658.21 vs 1841.96±552.39 pg/ml,p=0.001,),微栓子陽性組高于微栓子陰性組(2357.13±513.24 vs 1804.88±570.70pg/ml,p0.001)。用受試者曲線(ROC)分析血漿OPG預測神經(jīng)功能缺損嚴重性的可行性,ROC曲線下面積是0.734,臨界值是1998.44 pg/ml,敏感度80.6%,特異度65.6%。如果用血漿OPG的水平區(qū)分微栓子信號的發(fā)生,ROC曲線下面積0.766,臨界值2107.91pg/ml,敏感度68.8%,特異度73.7%。結論:血漿OPG水平和卒中的嚴重性及微栓子信號的發(fā)生明顯相關,血漿OPG也許能夠作為神經(jīng)功能缺損嚴重性及微栓子信號發(fā)生的一個生物學標志物。
[Abstract]:Background: the instability of atherosclerotic plaques is associated with the occurrence of stroke. Microemboli signal is a marker of plaque instability. We have identified a correlation between plasma osteoprotegerin (Osteoprotegerin,OPG) levels and stroke. Therefore, we investigate whether plasma OPG levels are associated with microemboli signal in patients with large atherosclerotic (large artery atherosclerosis,LAA type cerebral infarction. At the same time, whether plasma OPG can be used as a biological marker for evaluating the severity of neurologic impairment and the occurrence of microemboli signal at admission. Methods: according to TOAST classification, 127 patients with anterior circulation atherosclerotic cerebral infarction and 56 healthy controls were selected. The microemboli were monitored by transcranial Doppler (transcranial Doppler sonography,TCD (TCD) within 72 hours after onset of LAA cerebral infarction, and the monitoring time was 1 hour. According to the monitoring results, the patients with LAA type cerebral infarction were further divided into microemboli positive group and microemboli negative group. At the same time, the NIHSS (National Institutes of Health Stroke Scale) score on admission was recorded. According to NIHSS score, stroke patients were further divided into NIHSS Score 鈮，

本文編號：2257869