血管性痴呆患者抗心磷脂抗体与颈动脉内膜厚度及颈动脉狭窄的相关性研究
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摘要
目的探讨血管性痴呆(VD)患者抗心磷脂抗体(ACA)对颈动脉内膜厚度(IMT)和颈动脉狭窄的影响。方法以酶联免疫吸附法检测32例VD患者(VD组)和31名健康人(对照组)的血清ACA,VD组分为ACA阳性VD组和ACA阴性VD组,三组行颈动脉超声检查,比较三组患者颈动脉IMT及颈动脉狭窄程度。用SPSS 16.0软件进行统计学分析。结果 VD组和对照组ACA的阳性率分别为59.38%、16.13%,与对照组相比,VD组患者ACA阳性率明显偏高(χ2=12.49,P<0.05);ACA阳性VD组、ACA阴性VD组及对照组颈动脉IMT值分别为(1.32±0.12)mm、(1.15±0.10)mm、(0.90±0.07)mm,与ACA阴性组和对照组相比,ACA阳性VD组患者颈动脉IMT明显偏高(t值分别为5.043和15.393,均P<0.05);ACA阳性VD组、ACA阴性VD组及对照组颈动脉狭窄率分别为94.74%、53.85%、12.90%。与ACA阴性组和对照组相比,ACA阳性VD组患者颈动脉狭窄率明显偏高(χ2值分别为6.24和28.78,均P<0.05)。结论 VD患者ACA阳性率偏高,其可能与颈动脉IMT、颈动脉狭窄有关。
Objective To explore influence of anticardiolipin(ACA)on intima membrane thickness(IMT)and carotid artery stenosis in patients with vascular dementia(VD). Methods The content of ACA in blood serum of 32 VD patients( VD group) and 30 average healthy cases( control group) was detected by using ELISA methods,VD group was divided into ACA positive VD group and ACA negative VD group,IMT and carotid artery stenosis degree were detected by ultrasonic. Satistical analysis was performed by SPSS16. 0. Results The ACA positive rate were 59. 38%,16. 13% in VD group and control group respectively.The ACA positive rate in VD group was much higher than control group( χ2= 12. 49,P < 0. 05). The value of IMT were(1. 32 ± 0. 12) mm,( 1. 15 ± 0. 10) mm,( 0. 90 ± 0. 07) mm in ACA positive VD group,ACA negative VD group and control group respectively. The value of IMT in ACA positive VD group was much higher than ACA negative group and control group( t values were 5. 043 and 15. 393 respectively,all P <0. 05). The carotid artery stenosis rate were 94. 74%,53. 85%,12. 90% in VD group,cerebral infarction group and control group respectively. The carotid artery stenosis rate in ACA positive VD group was much higher than that in ACA negative VD group and control group( χ2values were 6. 24 and 28. 78 respectively,all P < 0. 05). Conclusion ACA positive rate is higher in VD patients,ACA may be related to IMT,carotid artery stenosis in VD patients.
Objective To explore influence of anticardiolipin(ACA)on intima membrane thickness(IMT)and carotid artery stenosis in patients with vascular dementia(VD). Methods The content of ACA in blood serum of 32 VD patients( VD group) and 30 average healthy cases( control group) was detected by using ELISA methods,VD group was divided into ACA positive VD group and ACA negative VD group,IMT and carotid artery stenosis degree were detected by ultrasonic. Satistical analysis was performed by SPSS16. 0. Results The ACA positive rate were 59. 38%,16. 13% in VD group and control group respectively.The ACA positive rate in VD group was much higher than control group( χ2= 12. 49,P < 0. 05). The value of IMT were(1. 32 ± 0. 12) mm,( 1. 15 ± 0. 10) mm,( 0. 90 ± 0. 07) mm in ACA positive VD group,ACA negative VD group and control group respectively. The value of IMT in ACA positive VD group was much higher than ACA negative group and control group( t values were 5. 043 and 15. 393 respectively,all P <0. 05). The carotid artery stenosis rate were 94. 74%,53. 85%,12. 90% in VD group,cerebral infarction group and control group respectively. The carotid artery stenosis rate in ACA positive VD group was much higher than that in ACA negative VD group and control group( χ2values were 6. 24 and 28. 78 respectively,all P < 0. 05). Conclusion ACA positive rate is higher in VD patients,ACA may be related to IMT,carotid artery stenosis in VD patients.
引文
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10 Garcia D,Akl EA,Carr R,et al.Antiphospholipid antibodies and the risk of recurrence after a first episode of venous thromboembolism:a systematic review[J].Blood,2013,122(5):817-824.
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12 潘剑罡,周海红,张惠婷.急性脑梗死患者血清抗心磷脂抗体、D-二聚体水平及临床意义[J].华夏医学,2014,27(1):41-43.
13 谭兰,苏净,刘震.抗磷脂抗体与血管性痴呆的相关性研究[J].山东医药,2001,41(19):3-5.
14 赵青菊,谭兰.Binswanger病人抗心磷脂抗体的检测[J].青岛大学医学院学报,2004,40(4):353-354,356.
15 Godoy JM,Godoy MR,Cipulo JP,et al.Vascular dementia and anticardiolipin antibodies[J].Med Sci Monit,2005,11(9):Cr430-433.
16 曾爱源,俸军林,吴岚.多梗死性痴呆与抗心磷脂抗体关系研究[J].华夏医学,2006,19(4):635-636.
17 屈继波,王文敏.急性脑梗死患者抗心磷脂抗体、抗中性粒细胞胞浆抗体与IMT及颈动脉狭窄的相关性[J].中国动脉硬化杂志,2012,4:356-360.
18 Homayoon N,Schwingenschuh P,Hofer E,et al.Anticardiolipin antibodies are associated with cognitive dysfunction in stroke-free individuals[J].Eur J Neurol,2014,21(3):427-432,e421-422.
19 Dietrich HH.Cell-to-cell communication and vascular dementia[J].Microcirculation,2012,19(5):461-467.
2 Lambert M,Bickel H,Prince M,et al.Estimating the burden of early onset dementia:systematic review of disease prevalence[J].Eur J Neurol,2014,21(4):563-569.
3 Lim W.Antiphospholipid syndrome[J].Hematology Am Soc Hematol Educ Program,2013,2013:675-680.
4 Shim H.Vascular cognitive impairment and post-stroke cognitive deficits[J].Curr Neurol Neurosci Rep,2014,14(1):1-6.
5 丁素菊.血管性痴呆[J].中国老年学杂志,2003,23(4):200-202.
6 杨申,李娟,宁方波.银杏叶提取物对血管性痴呆大鼠海马CA1区神经元凋亡及磷酸化p38MAPK表达的影响[J/CD].中华脑科疾病与康复杂志:电子版,2013,3(6):389-393.
7 Staub HL,Bertolaccini ML,Khamashta MA.Antiphosphatidylethanolamine antibody,thromboembolic events and the antiphospholipid syndrome[J].Autoimmun Rev,2012,12(2):230-234.
8 Ruiz-Irastorza G,Martinez-Berriotxoa A,Egurbide MV.The antiphospholipid syndrome in the 21st century[J].Med Clin(Barc),2009,133(10):390-396.
9 Garcia DA,Lim W.Should the presence of an antiphospholipid antibody affect the duration of anticoagulant treatment in patients with venous thromboembolism?[J].Hematology Am Soc Hematol Educ Program,2013,2013:681-683.
10 Garcia D,Akl EA,Carr R,et al.Antiphospholipid antibodies and the risk of recurrence after a first episode of venous thromboembolism:a systematic review[J].Blood,2013,122(5):817-824.
11 Kitagawa Y,Ohkuma H,Tokuoka K.Ischemic stroke with antiphospholipid antibody[J].Brain Nerve,2008,60(10):1144-1158.
12 潘剑罡,周海红,张惠婷.急性脑梗死患者血清抗心磷脂抗体、D-二聚体水平及临床意义[J].华夏医学,2014,27(1):41-43.
13 谭兰,苏净,刘震.抗磷脂抗体与血管性痴呆的相关性研究[J].山东医药,2001,41(19):3-5.
14 赵青菊,谭兰.Binswanger病人抗心磷脂抗体的检测[J].青岛大学医学院学报,2004,40(4):353-354,356.
15 Godoy JM,Godoy MR,Cipulo JP,et al.Vascular dementia and anticardiolipin antibodies[J].Med Sci Monit,2005,11(9):Cr430-433.
16 曾爱源,俸军林,吴岚.多梗死性痴呆与抗心磷脂抗体关系研究[J].华夏医学,2006,19(4):635-636.
17 屈继波,王文敏.急性脑梗死患者抗心磷脂抗体、抗中性粒细胞胞浆抗体与IMT及颈动脉狭窄的相关性[J].中国动脉硬化杂志,2012,4:356-360.
18 Homayoon N,Schwingenschuh P,Hofer E,et al.Anticardiolipin antibodies are associated with cognitive dysfunction in stroke-free individuals[J].Eur J Neurol,2014,21(3):427-432,e421-422.
19 Dietrich HH.Cell-to-cell communication and vascular dementia[J].Microcirculation,2012,19(5):461-467.