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急性缺血性脑卒中患者血清可溶性生长刺激表达基因2蛋白、脑钠肽与颈动脉粥样硬化程度的相关性

Correlations between serum soluble growth stimulationgene 2 protein, brain natriuretic peptide and the degree of carotid atherosclerosis in patients with acute ischemic stroke

    摘要
  • 摘要:
    目的 分析急性缺血性脑卒中患者血清可溶性生长刺激表达基因2蛋白(sST2)、脑钠肽(BNP)与颈动脉粥样硬化程度的相关性。
    方法 选取205例急性缺血性脑卒中患者为研究组，并根据颈动脉粥样硬化程度将其分为轻度组100例、中度组70例和重度组35例。另选同期接受体检的150例健康人员为对照组。比较各组血清sST2、BNP水平。分析sST2、BNP水平与颈动脉粥样硬化程度间的相关性。分析急性缺血性脑卒中患者颈动脉粥样硬化程度的影响因素。分析sST2、BNP联合评估对急性缺血性脑卒中患者颈动脉粥样硬化程度的预测价值。
    结果 研究组的血清sST2水平低于对照组，BNP水平高于对照组，差异有统计学意义(P < 0.05)。中度组、重度组的sST2水平低于轻度组, BNP水平高于轻度组，且重度组BNP水平高于中度组, sST2水平低于中度组，差异有统计学意义(P < 0.05)。急性缺血性脑卒中患者颈动脉粥样硬化程度与其年龄、有无高血压史、有无吸烟史、有无糖尿病史及总胆固醇(TC)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)、低密度脂蛋白(LDL)水平有关(P < 0.05)。年龄、高血压史、吸烟史、糖尿病史、TC、CRP、Hcy、LDL、BNP、sST2为患者颈动脉粥样硬化程度的影响因素(P < 0.05)。血清BNP水平与颈动脉粥样硬化程度呈正相关, sST2与颈动脉粥样硬化程度呈负相关(P < 0.001)。sST2、BNP联合预测的曲线下面积(AUC)大于sST2、BNP单独预测，差异有统计学意义(P < 0.001)。
    结论 临床观察急性缺血性脑卒中患者的血清sST2、BNP水平变化，可有效评估其疾病发展情况，有利于改善患者颈动脉粥样硬化程度。sST2、BNP联合评估对急性缺血性脑卒中患者颈动脉粥样硬化程度的诊断效能较好。

     

    Abstract:
    Objective To explore the correlations between serum soluble growth stimulation gene 2 protein (sST2), brain natriuretic peptide (BNP) and the degree of carotid atherosclerosis in patients with acute ischemic stroke.
    Methods A total of 205 patients with acute ischemic stroke were selected as study group, and were divided into mild group with 100 cases, moderate group with 70 cases, and severe group with 35 cases according to the severity of carotid atherosclerosis. Another 150 healthy people who received physical examination during the same period were selected as control group. Serum levels of sST2 and BNP were compared among all groups. The correlations of sST2 and BNP levels with the degree of carotid atherosclerosis were analyzed. The influencing factors of different degree of carotid atherosclerosis in patients with acute ischemic stroke were analyzed. The predictive value of sST2 combined with BNP on the degree of carotid atherosclerosis in patients with acute ischemic stroke was analyzed.
    Results The serum sST2 level of the study group was significantly lower than that of the control group, and the serum BNP level was significantly higher than that of the control group (P < 0.05). The sST2 levels in moderate and severe groups were significantly lower, BNP levels were significantly higher than that in the mild group (P < 0.05). BNP level in the severe group was significantly higher, sST2 level was significantly lower than that in the moderate group (P < 0.05). The degree of carotid atherosclerosis in patients with acute ischemic stroke was correlated with age, history of hypertension, history of smoking, history of diabetes, levels of total cholesterol (TC), C-reactive protein (CRP), homocysteine (Hcy) and low density lipoprotein (LDL) (P < 0.05). Age, hypertension history, smoking history, diabetes history, TC, CRP, Hcy, LDL, BNP and sST2 were the influencing factors for degree of carotid atherosclerosis (P < 0.05). Serum BNP level was positively correlated with the degree of carotid atherosclerosis, while sST2 level was negatively correlated with the degree of carotid atherosclerosis (P < 0.001). The area under the curve (AUC) for the combined prediction of sST2 and BNP was significantly greater than that for the individual prediction of sST2 and BNP (P < 0.001).
    Conclusion Clinical observation of the changes in serum levels of sST2 and BNP in patients with acute ischemic stroke can effectively assess the progression of the disease, which is beneficial for improving the severity of carotid atherosclerosis in patients. The combined assessment of sST2 and BNP shows good diagnostic performance for evaluating the severity of carotid atherosclerosis in patients with acute ischemic stroke.

     

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