急性脑梗塞病人血清瘦素与雌激素水平及其关系的研究
摘要
目的：观察急性脑梗塞病人血清瘦素、雌激素水平的变化，探讨血清瘦素、雌激素水平与患者性别、梗塞类型、血糖、血脂的关系。
方法：选择急性脑梗塞病人126例，在急性期测定血清瘦素、雌激素水平，同时测定空腹血糖、血脂水平，且与38例健康体检者进行对照。将观察对象分别以性别和脑梗塞类别分型，比较不同性别或梗塞分型时血清瘦素与雌激素的水平，并进行血清瘦素与雌激素、血糖、血脂之间的相关分析。
结果：①脑梗塞组的瘦素、雌激素水平显著高于对照组。②脑梗塞组中女性患者瘦素、雌激素水平显著高于男性患者。③以脑梗塞头颅CT病灶最大径影像结构分型，各分型之间瘦素、雌激素的水平差异无统计学意义。④相关分析表明急性脑梗塞患者血清瘦素与雌二醇、血糖、LDL均呈正相关；血清瘦素与HDL呈负相关。
结论：急性脑梗塞患者血清瘦素、雌激素水平升高，且女性患者升高更为明显。急性脑梗塞患者血清瘦素与雌激素、血糖、LDL水平之间存在正相关性，与HDL水平之间存在负相关性。观测急性脑梗死患者血清瘦素及雌激素水平对急性脑梗塞损伤程度及预后判断有一定的价值。
Objections To observe the changes of serum leptin and estradiol in patients with acute cerebral infarction, and to probe into the relationship of serum leptin level and estradiol, blood glucose and blood fat levels with different gender or imaging type of cerebral infarction.
Methods 126 patients with acute cerebral infarction and 38 synchronously examined healthy people (controls) were collected. The levels of serum leptin, estradiol, blood glucose and blood fat were detected in all the subjects. The patients with acute cerebral infarction were divided into different groups according to gender and imaging type. Changes of serum leptin and estradiol level were compared in patients with different gender and different imaging type. Correlation analysis was performed to serum leptin level and estradiol, blood glucose and blood fat levels.
Results The levels of serum leptin and estradiol were significantly higher in the acute cerebral infarction group than those in the control group, and the level of serum leptin and estradiol were significantly higher in female than male patients in cerebral infarction group. Correlation analysis results showed that the level of leptin was positively correlated with the levels of estradiol, blood glucose and LDL, and the level of leptin was negatively correlated with the level of HDL. Conclusions The levels of serum leptin and estradiol increase in patients with acute cerebral infarction,and the increasing is obvious specially in female patients.The level of serum leptin in patients with cerebral infarction is not only positively correlated with the level of estradiol,blood glucose and LDL,but also negatively correlated with the level of HDL,indicating that observing the levels of serum leptin and estradiol plays an important role in the evaluation of cerebral tissue injury degree and prognosis in patients with acute cerebral infarction.
方法：选择急性脑梗塞病人126例，在急性期测定血清瘦素、雌激素水平，同时测定空腹血糖、血脂水平，且与38例健康体检者进行对照。将观察对象分别以性别和脑梗塞类别分型，比较不同性别或梗塞分型时血清瘦素与雌激素的水平，并进行血清瘦素与雌激素、血糖、血脂之间的相关分析。
结果：①脑梗塞组的瘦素、雌激素水平显著高于对照组。②脑梗塞组中女性患者瘦素、雌激素水平显著高于男性患者。③以脑梗塞头颅CT病灶最大径影像结构分型，各分型之间瘦素、雌激素的水平差异无统计学意义。④相关分析表明急性脑梗塞患者血清瘦素与雌二醇、血糖、LDL均呈正相关；血清瘦素与HDL呈负相关。
结论：急性脑梗塞患者血清瘦素、雌激素水平升高，且女性患者升高更为明显。急性脑梗塞患者血清瘦素与雌激素、血糖、LDL水平之间存在正相关性，与HDL水平之间存在负相关性。观测急性脑梗死患者血清瘦素及雌激素水平对急性脑梗塞损伤程度及预后判断有一定的价值。
Objections To observe the changes of serum leptin and estradiol in patients with acute cerebral infarction, and to probe into the relationship of serum leptin level and estradiol, blood glucose and blood fat levels with different gender or imaging type of cerebral infarction.
Methods 126 patients with acute cerebral infarction and 38 synchronously examined healthy people (controls) were collected. The levels of serum leptin, estradiol, blood glucose and blood fat were detected in all the subjects. The patients with acute cerebral infarction were divided into different groups according to gender and imaging type. Changes of serum leptin and estradiol level were compared in patients with different gender and different imaging type. Correlation analysis was performed to serum leptin level and estradiol, blood glucose and blood fat levels.
Results The levels of serum leptin and estradiol were significantly higher in the acute cerebral infarction group than those in the control group, and the level of serum leptin and estradiol were significantly higher in female than male patients in cerebral infarction group. Correlation analysis results showed that the level of leptin was positively correlated with the levels of estradiol, blood glucose and LDL, and the level of leptin was negatively correlated with the level of HDL. Conclusions The levels of serum leptin and estradiol increase in patients with acute cerebral infarction,and the increasing is obvious specially in female patients.The level of serum leptin in patients with cerebral infarction is not only positively correlated with the level of estradiol,blood glucose and LDL,but also negatively correlated with the level of HDL,indicating that observing the levels of serum leptin and estradiol plays an important role in the evaluation of cerebral tissue injury degree and prognosis in patients with acute cerebral infarction.
引文
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[1] Dicou E, Attoub S, Gressens P.Neuroprotective effects of leptin in vivo and in vitro[J]. Neuroreport, 2001, 12(18): 3947-3951.
[2] Bado A, Levasseur S, Attoub S, et al. The stomach is a source of leptin[J]. Nature, 1998, 394(6695): 790-793.
[3] 周艳．瘦素及其研究进展[J]．医学综述，2004，10(1)：49-50．
[4] Bernard G, Leigh R, Paule B, et al. Plasma leptin concentrations in obese children: changes during 4-mo periods with and without physical training[J]. Am J ClinNutr, 1999, 89: 388-394.
[5] Machinal, Quelin F, Dieudonne MN, et al. Direct in vitro-effects of androgens and estrogens on ob gene expression and leptin secretion in human adipose tissue[J]. Endocrine, 2002, 18(2): 178-184.
[6] Fischer S, Hanefeld M, Haffner SM, et al. Insulin-resistant patients with type 2 diabetes mellitus have higher serum leptin levels independently of body fat mass[J]. Acta Diabetol, 2002, 39(3): 105-110.
[7] Tian Z, Sun R, WEI H, et al. Impaired natural killer (NK) cell activityin leptin receptor deficient mice: leptin as a critical regulator in NKcell development and activation[J]. Biochem Biophys Res Commun, 2002, 298(3): 297-302.
[8] Lord G. Role of leptin in immunology[J]. Nutr Rev, 2002, 60(10Pt2): 35-38.
[9] Kang SM, Kwon HM, Kim D, et al. Expression of leptin receptor inhuman atherosclemtic lesions: potential role in intimal neuvascularization [J]. Yonsei Med J, 2000, 41(1): 68.
[10] 杨志明，萧传实．促血管新生研究进展．中国动脉硬化杂志，2002，10：182-184．
[11] Aizawa-Abe M, Ogawa Y, Masuzaki H, et al. Pathophysiological role of leptin in obesity related hypertension[J]. Clin Invest, 2000, 105(9): 1243-1252.
[12] Shibuya I, Utsunomiya K, Toyohira Y, et al. Regulation of catecholamine synthesis by leptin[J]. AnnNYAcad Sci, 2002, 971: 522-527.
[13] Glander HJ, Lammert A, Paasch U, et al. Leptin exists in tubuli semi- niferi and in seminal plasma[J]. Andrologia, 2002, 34(4): 227-233.
[14] Bjorbaek C, Elmquist JK, Frantz JD, et al. Identification of SOCS - 3 as a potential mediator of centralleptin resistance[J]. Molcel-1, 1998, 1(4): 619-625.
[15] Hu FB, Chen C, Wang B, et al. Leptin concentration in relation to overall adiposity, fat distribution, and blood pressure in a rural Chinese population[J]. Int J Obes Relat Metab Disord, 2001, 25: 121-125.
[16] Stangl K, Cascobi I, Lanle M, et al. Elevated serum leptin in patients with coronary artery disease: no association with the Trp 64Arg polymorphism of the beta-adrenergic receptor[J]. Int J Obes RelatMetab Disord, 2000, 24(3): 369-375.
[17] Soderberg S, Ahren B, Jansson JH, et al. Leptin is associated with increased risk of myocardial infraction[J]. Intern Med, 1999, 246(4): 409.
[18] AI Daghri N, AI Rubuean K, Bartlett WA, et al. Serum leptin is elevated in Saudi Arabian patients with metabolic syndrome and coronary artery disease[J]. Diabet Med, 2003, 20(10): 832.
[19] Leyva F, Anker SD, Egerer K, et al. Hyperleptinaemia, in chronic heat failure, relationship with insulin[J]. Eur Heat J, 1998, 19: 1547-1551.
[20] Filippatos GS, Tsilias K, venetsanou K, et al. Leptin concentrations in relation to tumor necrosis factor - a system in cache tic heart failure patients[J]. Chest, 1999, 116(supp12): 3255-3260.
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[23] HastyAH, ShimanoH, OsugaJ, etal. Severe hypercholesterolemiahyper triglyceridemia, and atherosclerosis in mice lacking both leptin and lowdensity lipoproteinreceptor[J]. J BiolChem, 2001, 276(40): 37402-37408.
[24] 罗南萍，胡成进，王瑞山，等．血清瘦素水平与缺血性脑血管病关系的研究[J]．放射免疫学杂志，2004，17(4)：243-245．
[25] 孔敏，沈卫东．卒中后的神经内分泌功能失调．国外医学脑血管疾病分册[J]，2004，10(12)：757-761．
[26] 解建波，孙志清，陈玉芳．瘦素在脑梗死中的作用与机制．国外医学，2003，11(6)：452-455．
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[28] Quenhenbe ger P, Exner M, Sunder Plassmann R, et al. Leptin induces endothelin-1 in endothelial cells in vitro[J]. Circ Res, 2002, 90: 711-718.
[29] Belz shtsls, Towski J, Wojcicka G, et al. Leptin decrease plasma paraoxonase 1(PON 1)activity and induces oxidative stress: the possible novel machanism for proatherogenic effect of chronic hyperliptinemia[J]. Atherosclerosis, 2003, 170(1): 21.
[2] Bado A, Levasseur S, Attoub S, et al. The stomach is a source of leptin[J]. Nature, 1998, 394(6695): 790-793.
[3] Considine RV, Sinha MK, Heiman ML, et al. Serum immunore active leptin concentrations in normal weight and obese humans[J]. N Engl J Med, 1996, 334(5): 292-295.
[4] 周艳．瘦素及其研究进展[J]．医学综述，2004，10(1)：49-50．
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