血清OPG/RANKL比例与脑梗死病因亚型关系的研究
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摘要
目的:探讨脑梗死患者血清中的骨保素(OPG)/核因子kappa B受体活化因子配体(RANKL)比例与脑梗死病因亚型关系。方法:选取2016年2月至2018年1月青岛大学医学院附属医院神经内科住院的急性脑梗死患者中的157例,根据TOAST分型分为大动脉粥样硬化性脑梗死(LAA)和小动脉闭塞性脑梗死(SAO)两组,另外选取100例健康体检者作为对照组。采用酶联免疫吸附法(ELISA)分别检测三组血清中的OPG、RANKL水平,计算OPG/RANKL比例并比较;将同一病因亚型根据患者梗死体积分为大梗死组、中梗死组和小梗死组,比较三组血清中的OPG、RANKL水平及OPG/RANKL比例。结果:LAA组血清中OPG水平、OPG/RANKL比例均明显高于SAO组和对照组,LAA组血清中RANKL水平均明显低于SAO组和对照组,SAO组OPG/RANKL比例亦明显高于对照组,其差异均具有统计学意义(P<0.05)。在LAA中,大梗死组患者血清中OPG水平、OPG/RANKL比例均明显高于中梗死组和小梗死组,RANKL水平则明显低于中梗死组和小梗死组,中梗死组患者血清中OPG水平、OPG/RANKL比例均明显高于小梗死组,RANKL水平则明显低于小梗死组,其差异均具有统计学意义(P <0.05)。在SAO中,大梗死组SAO患者血清中OPG水平、OPG/RANKL比例均明显高于中梗死组和小梗死组,RANKL则明显低于梗死组和小梗死组;中梗死组SAO患者OPG/RANKL比例明显高于小梗死组,其差异均具有统计学意义(P <0.05)。结论:脑梗死患者血清中OPG/RANKL比例在LAA、SAO病因亚型患者中均随患者病情严重程度而增高,且不同病因亚型的OPG/RANKL比例存在明显差异,也许能够通过检测脑梗死患者血清中OPG、RANKL水平,计算OPG/RANKL比例判断其病情的严重程度。
Objective:To explore the relationship between the proportion of OPG/kappa B receptor activating factor ligand(RANKL)in the serum of cerebral infarction and the subtype of cerebral infarction.Methods:From February 2016to January2018,157patients with acute cerebral infarction admitted in the neurology department of hospital were divided into two groups:large atherosclerotic cerebral infarction(LAA)and arteriolo occlusive cerebral infarction(SAO).In addition,100patients were selected as the control group.The levels of OPG and RANKL in three groups of serum were detected by enzyme linked immunosorbent assay(ELISA),and the proportion of OPG/RANKL was calculated and compared.The same disease type was divided into large infarction group,middle infarction group and small infarction group according to the infarct volume.The OPG,RANKL level and OPG/RANKL ratio in the serum of the three groups were compared.Results:the serum level of OPG and OPG/RANKL in serum of LAA group were significantly higher than that in group SAO and control group.The level of RANKL in serum of LAA group was significantly lower than that of group SAO and control group,and the proportion of OPG/RANKL in SAO group was significantly higher than that in control group,and the difference was statistically significant(P<0.05).In LAA,the level of OPG and OPG/RANKL in the serum of the large infarct group were significantly higher than that of the middle infarction group and the small infarction group.The level of RANKL was significantly lower than that in the middle and small infarct groups.The level of OPG and the OPG/RANKL in the serum of the patients in the middle infarct group were significantly higher than those in the small infarction group,and the RANKL level was significantly lower than that of the small infarction group.All of them were statistically significant(P<0.05).In SAO,the serum levels of OPG and OPG/RANKL in the patients with SAO in the large infarct group were significantly higher than those in the middle and small infarct groups.RANKL was significantly lower than that in the infarct group and the small infarct group.The proportion of OPG/RANKL in the middle infarction group was significantly higher than that in the small infarction group,and the difference was statistically significant(P<0.05).Conclusion:The proportion of OPG/RANKL in the serum of patients with cerebral infarction increased with the severity of the patients in LAA and SAO etiological subtypes,and the proportion of OPG/RANKL in different etiological subtypes was significantly different.It may be able to determine the severity of the disease by measuring the level of OPG and RANKL in the serum of the patients with cerebral infarction.
Objective:To explore the relationship between the proportion of OPG/kappa B receptor activating factor ligand(RANKL)in the serum of cerebral infarction and the subtype of cerebral infarction.Methods:From February 2016to January2018,157patients with acute cerebral infarction admitted in the neurology department of hospital were divided into two groups:large atherosclerotic cerebral infarction(LAA)and arteriolo occlusive cerebral infarction(SAO).In addition,100patients were selected as the control group.The levels of OPG and RANKL in three groups of serum were detected by enzyme linked immunosorbent assay(ELISA),and the proportion of OPG/RANKL was calculated and compared.The same disease type was divided into large infarction group,middle infarction group and small infarction group according to the infarct volume.The OPG,RANKL level and OPG/RANKL ratio in the serum of the three groups were compared.Results:the serum level of OPG and OPG/RANKL in serum of LAA group were significantly higher than that in group SAO and control group.The level of RANKL in serum of LAA group was significantly lower than that of group SAO and control group,and the proportion of OPG/RANKL in SAO group was significantly higher than that in control group,and the difference was statistically significant(P<0.05).In LAA,the level of OPG and OPG/RANKL in the serum of the large infarct group were significantly higher than that of the middle infarction group and the small infarction group.The level of RANKL was significantly lower than that in the middle and small infarct groups.The level of OPG and the OPG/RANKL in the serum of the patients in the middle infarct group were significantly higher than those in the small infarction group,and the RANKL level was significantly lower than that of the small infarction group.All of them were statistically significant(P<0.05).In SAO,the serum levels of OPG and OPG/RANKL in the patients with SAO in the large infarct group were significantly higher than those in the middle and small infarct groups.RANKL was significantly lower than that in the infarct group and the small infarct group.The proportion of OPG/RANKL in the middle infarction group was significantly higher than that in the small infarction group,and the difference was statistically significant(P<0.05).Conclusion:The proportion of OPG/RANKL in the serum of patients with cerebral infarction increased with the severity of the patients in LAA and SAO etiological subtypes,and the proportion of OPG/RANKL in different etiological subtypes was significantly different.It may be able to determine the severity of the disease by measuring the level of OPG and RANKL in the serum of the patients with cerebral infarction.
引文
[1]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,02(02):16-19.
[2]Marley K,Bracha S,Seguin B.Osteoprotegerin activates osteosarcoma cells that co-express RANK and RANKL[J].Exp CellRes,2015,338(01):32-38.
[3]Pérez de Ciriza C,Lawrie A,Varo N.Osteoprotegerin in cardiometabolic disorders[J].Int J Endocrinol,2015,20(15):564-571.
[4]陈艳洁,于文霞,王彦,等.丁苯酞注射液治疗急性脑梗死的疗效及对血清中sTRAIL、OPG和TNF-α的影响[J].现代中西医结合杂志,2014,23(23):2580-2582.
[5]李文武.急性脑梗死TOAST分型尿激酶静脉溶栓治疗198例临床疗效分析[J].大理大学学报,2017,02(04):41-45.
[6]Adams H P Jr,Bendixen B H,Kappelle L J,et al.Classification of subtype of acute ischemic stroke.Definitions for use in a multicenter clinical trial TOAST Trial of Org 10172in A-cute Stroke Treatment[J].Stroke,2013,24(05):35-41.
[7]Stein J H,Korcarz C E,Hurst R T,et al.Use of carotid ultrasound toidentify subclinical vascular disease and evaluate cardiovascular disease risk:a consensus statement from the A-merican society of echo cardiography Intima-Media thickness taskforce[J].Journal of the American Society of Echocardiography,2008,21(02):189-190.
[8]李玲,杜秦川,马瑞莲,等.血清RANKL和脑梗死患者动脉粥样硬化性脑梗死的相关性研究[J].宁夏医学杂志,2016,38(06):487-488.
[9]凌芳,李强,聂德云.急性脑梗死患者血清HMGB1、OPG和MIF水平的变化及PAS三联疗法的干预作用[J].中华脑血管病杂志(电子版),2014,06(02):87-89.
[10]刘利宁,王满侠,秦敏,等.急性脑梗死患者血清sTRAIL、OPG水平与TOAST亚型的关系[J].中风与神经疾病杂志,2015,28(02):141-144.
[11]王潇,冯娟.血清骨保护素水平与急性脑梗死病因亚型及严重程度的关系[J].中国神经医学杂志,2014,13(02):265-267.
[12]赵学廉,方敬献.急性脑梗死患者血清骨保护素含量的改变及其临床意义[J].国际老年医学杂志,2016,37(03):100-101.
[13]Sandberg W J,Yndestad A,Oie E,et al.Enhanced T-cell expression of RANK ligand in acute coronarysyndrome:possible role in plaque destabilization[J].Arterioscler Thromb Vasc Biol,2006,26(04):857-863.
[2]Marley K,Bracha S,Seguin B.Osteoprotegerin activates osteosarcoma cells that co-express RANK and RANKL[J].Exp CellRes,2015,338(01):32-38.
[3]Pérez de Ciriza C,Lawrie A,Varo N.Osteoprotegerin in cardiometabolic disorders[J].Int J Endocrinol,2015,20(15):564-571.
[4]陈艳洁,于文霞,王彦,等.丁苯酞注射液治疗急性脑梗死的疗效及对血清中sTRAIL、OPG和TNF-α的影响[J].现代中西医结合杂志,2014,23(23):2580-2582.
[5]李文武.急性脑梗死TOAST分型尿激酶静脉溶栓治疗198例临床疗效分析[J].大理大学学报,2017,02(04):41-45.
[6]Adams H P Jr,Bendixen B H,Kappelle L J,et al.Classification of subtype of acute ischemic stroke.Definitions for use in a multicenter clinical trial TOAST Trial of Org 10172in A-cute Stroke Treatment[J].Stroke,2013,24(05):35-41.
[7]Stein J H,Korcarz C E,Hurst R T,et al.Use of carotid ultrasound toidentify subclinical vascular disease and evaluate cardiovascular disease risk:a consensus statement from the A-merican society of echo cardiography Intima-Media thickness taskforce[J].Journal of the American Society of Echocardiography,2008,21(02):189-190.
[8]李玲,杜秦川,马瑞莲,等.血清RANKL和脑梗死患者动脉粥样硬化性脑梗死的相关性研究[J].宁夏医学杂志,2016,38(06):487-488.
[9]凌芳,李强,聂德云.急性脑梗死患者血清HMGB1、OPG和MIF水平的变化及PAS三联疗法的干预作用[J].中华脑血管病杂志(电子版),2014,06(02):87-89.
[10]刘利宁,王满侠,秦敏,等.急性脑梗死患者血清sTRAIL、OPG水平与TOAST亚型的关系[J].中风与神经疾病杂志,2015,28(02):141-144.
[11]王潇,冯娟.血清骨保护素水平与急性脑梗死病因亚型及严重程度的关系[J].中国神经医学杂志,2014,13(02):265-267.
[12]赵学廉,方敬献.急性脑梗死患者血清骨保护素含量的改变及其临床意义[J].国际老年医学杂志,2016,37(03):100-101.
[13]Sandberg W J,Yndestad A,Oie E,et al.Enhanced T-cell expression of RANK ligand in acute coronarysyndrome:possible role in plaque destabilization[J].Arterioscler Thromb Vasc Biol,2006,26(04):857-863.