不同梗死面积、神经功能缺损程度、预后的急性脑梗死患者血清Chemerin和Omentin-1水平对比观察
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摘要
目的对比不同梗死面积、不同神经功能缺损程度、不同预后的急性脑梗死(ACI)患者血清趋化素(Chemerin)、网膜素-1(Omentin-1)水平。方法选取108例ACI患者作为观察组,其中大面积脑梗死12例(梗死最大直径≥5 cm)、中面积脑梗死37例(梗死最大直径>3～5 cm)、小面积脑梗死40例(梗死最大直径1.5～3 cm)、腔隙性脑梗死19例(梗死最大直径<1.5 cm),神经功能缺损程度为重度19例(NIHSS评分>15分)、中度45例(15分≥NIHSS评分>5分)、轻度44例(NIHSS评分≤5分)。对ACI患者随访90 d,预后良好(mRS≤2分)83例和预后不良(mRS>2分)25例。另择100例非ACI患者作为对照组。采用酶联免疫吸附实验双抗体夹心法检测观察组发病<48 h、第7天及对照组入院当天血清Chemerin、Omentin-1水平,并对上述不同组间血清Chemerin、Omentin-1水平进行比较。Pearson相关分析观察组血清Chemerin、Omentin-1水平与NIHSS评分的关系。结果与对照组比较,观察组发病<48 h、第7天血清Chemerin水平均高(P均<0.01),血清Omentin-1水平均低(P均<0.01)。同时间ACI患者血清Chemerin水平比较,大面积脑梗死>中面积脑梗死>小面积脑梗死、腔隙性脑梗死,重度神经功能缺损程度>中度神经功能缺损程度>轻度神经功能缺损程度,P均<0.05;同时间ACI患者Omentin-1水平比较:大、中面积脑梗死<小面积脑梗死<腔隙性脑梗死,重度神经功能缺损程度<中度神经功能缺损程度<轻度神经功能缺损程度,P均<0.05。与同组发病<48 h比较,发病第7天不同脑梗死面积及不同神经功能缺损程度的脑梗死患者血清Chemerin水平降低、Omentin-1水平升高(P均<0.05)。ACI发病<48 h、第7天血清Chemerin水平与NIHSS评分呈正相关(r=0.806,P<0.01;r=0.749,P<0.01),血清Omentin-1水平与NIHSS评分呈负相关(r=-0.684,P<0.01;r=-0.588,P<0.01)。与预后良好组比较,ACI预后不良组患者血清Chemerin水平高,Omentin-1水平低(P均<0.05)。结论脑梗死面积大、神经功能缺损程度大、预后差的ACI患者血清Chemerin水平升高、Omentin-1水平降低。
Objective To observe the changes of serum chemerin and omentin-1 levels in acute cerebral infarction(ACI) patients with different infarct sizes, degree of neurological deficit, and prognosis, and to explore the relationships of serum chemerin and omentin-1 levels with ACI. Methods Totally 108 patients with ACI were selected as the observation group, grouped by infarct size: 12 patients with large area ACI(maximum diameter ≥5 cm), 37 patients with middle area ACI(5 cm > maximum diameter ≥3 cm), 40 patients with small area ACI(3 cm>maximum diameter ≥1.5 cm), and 19 patients with lacunar infarction(maximum diameter <1.5 cm); grouped by neurological deficits: 19 severe patients(NIHSS score >15), 45 moderate patients( 15≥ NIHSS score >5), and 44 mild patients(NIHSS score ≤5). All patients with ACI were followed up for 90 days, and the prognosis was good(mRS ≤2) in 83 cases and poor prognosis(mRS >2) in 25 cases. Another 100 cases of non-ACI persons were selected as the control group. Enzyme-linked immunosorbent assay(ELISA) was used to detect and compare the serum levels of chemerin and omentin-1 in the observation group(within 48 h of the onset and at 7 d after ACI) and control group(on the day of admission). Pearson correlation analysis was used to analyze the correlation between the serum levels of chemerin and omentin-1 and NIHSS score in the observation group. Results Compared with the control group, the serum chemerin levels were higher at 48 h and 7 d after ACI, respectively, and serum omentin-1 levels were lower in the observation group(all P<0.01). At the same time, the serum Chemerin levels in ACI patients were in the following order: large area ACI> middle area ACI> small area ACI, lacunar infarction, severe>moderate>mild(all P<0.05); comparison in the omentin-1 levels: large and medium area ACI
Objective To observe the changes of serum chemerin and omentin-1 levels in acute cerebral infarction(ACI) patients with different infarct sizes, degree of neurological deficit, and prognosis, and to explore the relationships of serum chemerin and omentin-1 levels with ACI. Methods Totally 108 patients with ACI were selected as the observation group, grouped by infarct size: 12 patients with large area ACI(maximum diameter ≥5 cm), 37 patients with middle area ACI(5 cm > maximum diameter ≥3 cm), 40 patients with small area ACI(3 cm>maximum diameter ≥1.5 cm), and 19 patients with lacunar infarction(maximum diameter <1.5 cm); grouped by neurological deficits: 19 severe patients(NIHSS score >15), 45 moderate patients( 15≥ NIHSS score >5), and 44 mild patients(NIHSS score ≤5). All patients with ACI were followed up for 90 days, and the prognosis was good(mRS ≤2) in 83 cases and poor prognosis(mRS >2) in 25 cases. Another 100 cases of non-ACI persons were selected as the control group. Enzyme-linked immunosorbent assay(ELISA) was used to detect and compare the serum levels of chemerin and omentin-1 in the observation group(within 48 h of the onset and at 7 d after ACI) and control group(on the day of admission). Pearson correlation analysis was used to analyze the correlation between the serum levels of chemerin and omentin-1 and NIHSS score in the observation group. Results Compared with the control group, the serum chemerin levels were higher at 48 h and 7 d after ACI, respectively, and serum omentin-1 levels were lower in the observation group(all P<0.01). At the same time, the serum Chemerin levels in ACI patients were in the following order: large area ACI> middle area ACI> small area ACI, lacunar infarction, severe>moderate>mild(all P<0.05); comparison in the omentin-1 levels: large and medium area ACI
引文
[1] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682.
[2] Zylla S, Dorr M, Vozke H, et al. Association of circulating chemerin with subclinical parameters of atherosclerosis: results of a population-based study [J]. Arterioscler Thromb Vasc Biol, 2018,38(7):1656-1664.
[3] Zhao D, Bi G, Feng J, et al. Association of serum chemerin levels with acute ischemic stroke and carotid artery atherosclerosis in a chinese population[J]. Med Sci Monit, 2015,21:3121-3128.
[4] Hiramatsuito M, Shibata R, Ohashi K, et al. Omentin attenuates atherosclerotic lesion formation in apolipoprotein E-deficient mice [J]. Cardiovas Res, 2015,110(1):107-117.
[5] 贾瑞超,张玺,毕璐洁,等.2型糖尿病合并脑梗死与网膜素-1的相关性研究[J].实用临床医学,2014,15(2):3-6.
[6] McCarthy TC, Zuniga LA, Zabe BA, et al. The novel adipokinechemerin significantly increases cholesterol uptake in humanmacrophages [J]. FASEB J, 2008,22(4):948-952.
[7] 彭清,卢建刚,范忠才,等.动脉粥样硬化大鼠Chemerin与炎症的相关性[J].中国动脉硬化杂志,2014,22(8):789-794.
[8] Yang RZ, Lee MJ, Hu H, et al. Identification of omentin as a novel epot-specific adipokine in human adipose tissue: possible role in modulating insulin action [J]. Am J Physiol Endocrinol Metab, 2006,290(6):E1253-E1261.
[9] Yamawaki H. Vascular effects of novel adipocytokines: focus on vascular contractility and inflammatory responses [J]. Biol Pharm Bull, 2011,34(3):307-310.
[10] Kammerer A, Staab H, Herberg M, et al. Increased circulating chemerin in patients with advanced carotid stenosis[J]. BMC Cardiovasc Disord, 2018,18(1):65.
[11] Wang XH, Dou LZ, Gu C, et al. Plasma levels of omentin-1 and visfatin in senile patients with coronary heart disease and heart failure[J]. Asian Pac J Trop Med, 2014,7(1):55-62.
[12] Zhao D, Bi G, Feng J, et al. Association of serum chemerin levels with acute ischemic stroke and carotid artery atherosclerosis in a chinese population[J]. Med J Exp Clin Res, 2015,21:3121-3128.
[13] Xu T, Zuo P, Wang Y, et al. Serum omentin-1 is a novel biomarker for predicting the functional outcome of acute ischemic stroke patients [J]. Clin Chem Lab Med, 2018,56(2):350-355.
[2] Zylla S, Dorr M, Vozke H, et al. Association of circulating chemerin with subclinical parameters of atherosclerosis: results of a population-based study [J]. Arterioscler Thromb Vasc Biol, 2018,38(7):1656-1664.
[3] Zhao D, Bi G, Feng J, et al. Association of serum chemerin levels with acute ischemic stroke and carotid artery atherosclerosis in a chinese population[J]. Med Sci Monit, 2015,21:3121-3128.
[4] Hiramatsuito M, Shibata R, Ohashi K, et al. Omentin attenuates atherosclerotic lesion formation in apolipoprotein E-deficient mice [J]. Cardiovas Res, 2015,110(1):107-117.
[5] 贾瑞超,张玺,毕璐洁,等.2型糖尿病合并脑梗死与网膜素-1的相关性研究[J].实用临床医学,2014,15(2):3-6.
[6] McCarthy TC, Zuniga LA, Zabe BA, et al. The novel adipokinechemerin significantly increases cholesterol uptake in humanmacrophages [J]. FASEB J, 2008,22(4):948-952.
[7] 彭清,卢建刚,范忠才,等.动脉粥样硬化大鼠Chemerin与炎症的相关性[J].中国动脉硬化杂志,2014,22(8):789-794.
[8] Yang RZ, Lee MJ, Hu H, et al. Identification of omentin as a novel epot-specific adipokine in human adipose tissue: possible role in modulating insulin action [J]. Am J Physiol Endocrinol Metab, 2006,290(6):E1253-E1261.
[9] Yamawaki H. Vascular effects of novel adipocytokines: focus on vascular contractility and inflammatory responses [J]. Biol Pharm Bull, 2011,34(3):307-310.
[10] Kammerer A, Staab H, Herberg M, et al. Increased circulating chemerin in patients with advanced carotid stenosis[J]. BMC Cardiovasc Disord, 2018,18(1):65.
[11] Wang XH, Dou LZ, Gu C, et al. Plasma levels of omentin-1 and visfatin in senile patients with coronary heart disease and heart failure[J]. Asian Pac J Trop Med, 2014,7(1):55-62.
[12] Zhao D, Bi G, Feng J, et al. Association of serum chemerin levels with acute ischemic stroke and carotid artery atherosclerosis in a chinese population[J]. Med J Exp Clin Res, 2015,21:3121-3128.
[13] Xu T, Zuo P, Wang Y, et al. Serum omentin-1 is a novel biomarker for predicting the functional outcome of acute ischemic stroke patients [J]. Clin Chem Lab Med, 2018,56(2):350-355.