进展性脑梗死患者血清Vaspin表达与炎症因子的关系-现代医学

进展性脑梗死患者血清Vaspin表达与炎症因子的关系

单位：衡水市人民医院/哈励逊国际和平医院神经内科, 河北衡水 053000

分类号：R743.3

出版年·卷·期（页码）：2021·49·第九期（1006-1011）

摘要：

目的：通过检测进展性脑梗死（PCI）患者血清中内脏脂肪特异性丝氨酸蛋白酶抑制剂（Vaspin）的表达情况，探究其与炎症因子的关系。方法：选取2018年6月至2020年8月本院神经内科收治确诊的105例PCI患者作为PCI组，98例非PCI患者作为NPCI组，同时期健康体检者95例作为对照组。使用全自动生化分析仪检测总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）水平；酶联免疫吸附实验（ELISA）检测Vaspin、单核细胞趋化蛋白-1（MCP-1）、白介素17（IL-17）、肿瘤坏死因子α（TNF-α）和降钙素原（PCT）、超敏C反应蛋白（hs-CRP）水平；Vaspin与MCP-1、IL-17、TNF-α、hs-CRP及PCT间相关性采用Pearson相关系数法进行分析；受试者工作特征（ROC）曲线评估Vaspin对PCI的诊断价值；使用Logistic回归分析影响PCI发生的因素。结果：NPCI组和PCI组TC、TG、LDL-C、MCP-1、IL-17、TNF-α、hs-CRP和PCT水平显著高于对照组，而HDL-C和Vaspin水平则显著低于对照组（P<0.05）；PCI组TC、TG、LDL-C、MCP-1、IL-17、TNF-α、hs-CRP和PCT水平显著高于NPCI组，而HDL-C和Vaspin水平则显著低于NPCI组（P<0.05）；血清中Vaspin水平随疾病进展程度加重而降低（P<0.05）；Vaspin与MCP-1、IL-17、TNF-α、hs-CRP、PCT均呈负相关（P<0.05）；Vaspin评估PCI发生的ROC曲线下面积为0.914；多因素分析发现低水平Vaspin和HDL-C，高水平MCP-1、IL-17、TNF-α、hs-CRP、PCT、TC、TG和LDL-C均是导致PCI发生的独立危险因素（P<0.05）。结论：PCI患者血清中Vaspin水平与炎症因子密切相关，对疾病诊断及临床监测具有重要参考价值。

Objective: To detect the expression of visceral adipose-specific serine protease inhibitor (Vaspin) in the serum of patients with progressive cerebral infarction (PCI), and to explore its relationship with inflammatory factors. Methods: From June 2018 to August 2020, 105 patients with PCI in the department of neurology of our hospital were selected as the PCI group, 98 patients with non-progressive cerebral infarction were selected as the NPCI group, and 95healthy physical examination person during the same period were selected as the control group; the automatic biochemical analyzer was used to detect levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C); ELISA method was used to detect the levels of Vaspin, monocyte chemoattractant protein-1 (MCP-1), interleukin-17 (IL-17), tumor necrosis factor-α (TNF-α) and procalcitonin (PCT), high sensitivity C-reactive protein (hs-CRP); Pearson correlation coefficient method was used to analyze the correlation between Vaspin and MCP-1, IL-17, TNF-α, hs-CRP and PCT; the receiver operating characteristic(ROC) curve was used to assess Vaspin's diagnostic value for PCI; Logistic regression was used to analyze the factors affecting the occurrence of PCI. Results: Compared with the control group, the levels of TC, TG, LDL-C, MCP-1, IL-17, TNF-α, hs-CRP and PCT in the NPCI group and the PCI group increased significantly, while the levels of HDL-C and Vaspin decreased significantly (P<0.05); compared with the NPCI group, the levels of TC, TG, LDL-C, MCP-1, IL-17, TNF-α, hs-CRP and PCT in the PCI group increased significantly, while the levels of HDL-C and Vaspin decreased significantly (P<0.05); the level of Vaspin in the serum decreased with the degree of progression (P<0.05); Vaspin had a negative correlation with MCP-1, IL-17, TNF-α, hs-CRP, and PCT (P<0.05); the area under the ROC curve of Vaspin in the assessment of PCI was 0.914; multivariate analysis found that low level of Vaspin and HDL-C, high levels of MCP-1, IL-17, TNF-α, hs-CRP, PCT, TC, TG and LDL-C were independent risk factors for PCI (P<0.05). Conclusion: The level of Vaspin in the serum of PCI patients is closely related to inflammatory factors, which has important reference value for disease diagnosis and clinical monitoring.

参考文献：

[1] 杨阳, 孙博谦.进展性脑梗死危险因素研究进展[J]. 中国保健营养, 2020, 30(22):49.
[2] 田小全, 王玉芬, 刘红.进展性脑梗死相关危险因素研究进展[J]. 临床医药实践, 2019, 28(1):62-66.
[3] 张静静, 吕荣祥, 刘郁, 等.老年急性脑梗死患者血尿酸、凝血功能、炎症因子和血液流变学指标的变化[J]. 中国老年学杂志, 2018, 38(8):1815-1817.
[4] 李雪媛.阿替普酶静脉溶栓治疗对急性脑梗死患者血清中Vaspin和血液流变学及认知功能的影响[J]. 当代医学, 2020, 26(2):22-24.
[5] 李芳, 潘发光, 刘芳.脑梗死患者血清vaspin、apelin、chemerin与颈动脉斑块性质及预后的关系[J]. 热带医学杂志, 2019, 19(3):346-349, 368.
[6] 彭敏.急性脑梗死静脉溶栓患者NIHSS评分与MESSS评分的应用价值评价[J]. 基层医学论坛, 2018, 22(4):446-448.
[7] 李柏林, 梁春娜, 谭文静, 等.进展性脑梗死患者血清CTRP3的表达及其与炎症因子的相关性[J/OL].中华脑科疾病与康复杂志(电子版), 2019, 9(2):87-90.
[8] 胡会平.进展性脑梗死的相关影响因素[J]. 当代医药论丛, 2020, 18(12):32-33.
[9] 刘书芳.替罗非班治疗急性进展性脑梗死效果及对炎症水平影响[J]. 临床研究, 2020, 28(11):51-52.
[10] 何诺, 谢林森, 董丽, 等.炎症因子表达及凝血相关指标检验对急性进展性脑梗死患者病情评估的效果分析[J]. 山西医药杂志, 2020, 49(24):3483-3485.
[11] 韩雨珈, 金玉玲.进展性脑梗死患者血清25-(OH) D₃与MCP-1水平的关系[J]. 医学信息, 2020, 33(6):110-111.
[12] 刘秀兰, 陈莉云, 赵晓茹, 等.丁苯酞治疗急性进展性脑梗死的临床效果及对炎性因子的影响[J]. 解放军医药杂志, 2019, 31(6):69-72.
[13] 于子忠.进展性脑梗死患者血清IL-17动态变化的临床研究[J]. 白求恩军医学院学报, 2019, 17(4):343-344.
[14] 任爱琨, 王勇, 孙艳霞, 等.Hcy、Hs-CRP、D-二聚体水平检测对进展性脑梗死的预测价值[J]. 医药前沿, 2019, 9(8):110-112.
[15] 王晓萍, 彭军, 姜丹, 等.纳络酮对脑梗塞患者血清降钙素原及叶酸水平及临床疗效的影响[J]. 现代生物医学进展, 2017, 17(1):77-79, 103.
[16] GUO M, CHEN M L, LI C Q, et al. Research progress of vaspin in cardiovascular diseases[J]. Med Recapitulate, 2016, 22(13):2526-2529.
[17] 王丽, 林翔东, 倪桂莲.急性脑梗死患者血清Vaspin, Omentin-1水平及其临床意义[J]. 浙江临床医学, 2016, 18(3):415-417.
[18] 肖瑶, 沈伟, 张静, 等.脂肪因子Vaspin与老年缺血性脑血管病的相关性及其作用机制[J]. 中国老年学杂志, 2016, 36(16):3940-3942.
[19] 张俊, 高焱.后循环脑梗死患者血清中血小板活化因子含量与炎症反应指标及血脂代谢的相关性[J]. 海南医学院学报, 2018, 24(5):636-639.
[20] 刘师伟, 王明明, 王军, 等.Vaspin对HUVECs中TNF-α介导的NF-κB和PI3K/Akt信号通路的影响[J]. 基础医学与临床, 2015, 35(8):1020-1024.
[21] 汪笋, 陈天华, 彭惠, 等.糖尿病肾病患者中炎症指标和血清Vaspin水平的关系[J]. 广东医学, 2017, 38(1):111-114.
[22] 蒋宾, 曹莉梅, 董能斌, 等.冠心病患者血清Vaspin和MCP-1水平变化及与患者心肌损伤程度及心功能的相关性分析[J]. 河北医学, 2020, 26(12):1986-1991.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录