摘要
目的探讨脑梗死患者血浆晚期糖基化终产物(advanced glycation end products, AGEs)、一氧化氮(nitric oxide, NO)水平与颈动脉粥样硬化的关系。方法选取脑梗死112例作为脑梗死组,健康体检者50例作为对照组。根据美国国立卫生研究院卒中评定量表评分评价脑梗死病情程度,脑梗死112例中轻度44例,中度38例,重度30例。超声检查结果显示脑梗死112例中颈动脉粥样斑块形成76例,非粥样斑块形成36例。比较脑梗死组和对照组、不同病情程度脑梗死患者血浆AGEs、NO水平和颈总动脉分叉处内中膜厚度(intima-medium thickness, IMT),粥样斑块形成与非粥样斑块形成脑梗死患者血浆AGEs和NO水平,并采用Spearman等级相关分析对血浆AGEs、NO水平和颈总动脉分叉处IMT与脑梗死病情程度关系以及血浆AGEs、NO水平与脑梗死患者粥样斑块形成关系进行分析。结果脑梗死组血浆AGEs水平及颈总动脉分叉处IMT高于对照组,血浆NO水平低于对照组,差异有统计学意义(P<0.01)。不同病情程度脑梗死患者间血浆AGEs、NO水平和颈总动脉分叉处IMT总体比较差异有统计学意义(P<0.01)。轻度脑梗死患者血浆AGEs水平和颈总动脉分叉处IMT低于中度和重度脑梗死患者,血浆NO水平高于中度和重度脑梗死患者;中度脑梗死患者血浆AGEs水平和颈总动脉分叉处IMT低于重度脑梗死患者,血浆NO水平高于重度脑梗死患者,差异有统计学意义(P<0.05或P<0.01)。粥样斑块形成脑梗死患者血浆AGEs水平高于非粥样斑块形成脑梗死患者,血浆NO水平低于非粥样斑块形成脑梗死患者,差异均有统计学意义(P<0.01)。Spearman等级相关分析结果显示,血浆AGEs水平与脑梗死病情程度呈正相关,血浆NO水平与脑梗死病情程度呈负相关,颈总动脉分叉处IMT与脑梗死病情程度呈正相关;血浆AGEs水平与脑梗死粥样斑块形成呈正相关,血浆NO水平与脑梗死粥样斑块形成呈负相关。结论血浆AGEs、NO水平异常与脑梗死及颈动脉粥样硬化的发生和发展相关,血浆AGEs、NO水平检测可了解颈动脉粥样硬化进展情况,且对评估脑梗死患者病情程度具有重要意义。
Objective To explore the relationship between levels of plasma advanced glycation end products(AGEs), nitric oxide(NO) and carotid atherosclerosis(CAS) in patients with cerebral infarction(CI). Methods A total of 112 patients with CI and 50 healthy people who underwent physical examination were selected and included in the CI group and the control group, respectively. The severity of CI was evaluated with the National Institutes of Health Stroke Scale score, and the results showed that of the 112 cases with CI, there were 44 mild cases, 38 moderate cases and 30 severe cases. The results of ultrasonography revealed that of the 112 CI cases, there were 76 cases with CAS and 36 cases without CAS. Plasma AGEs and NO levels, as well as the intima-media thickness(IMT) in the bifurcation of common carotid artery were compared between the CI group and the control group, between patients with different severities of CI. Plasma AGEs and NO levels in patients with CAS and those without CAS were also compared. Spearman rank correlation analysis was used to analyze the relationship between plasma AGEs, NO levels, IMT in the bifurcation of common carotid artery and the severity of CI, and the relationship between plasma AGEs, NO levels and formation of CAS. Results The plasma AGEs level and IMT in the bifurcation of common carotid artery in the CI group were significantly higher than those in the control group, while the plasma NO level was significantly lower than that in the control group(P<0.01). There were significant differences in plasma AGEs, NO levels and IMT in the bifurcation of common carotid artery between patients with different severities of CI(P<0.01). In patients with mild CI, levels of plasma AGEs, NO and IMT in the bifurcation of common carotid artery were significantly lower, and plasma NO levels were significantly higher than those in patients with moderate and severe CI(P<0.05 or P<0.01). In patients with moderate CI, plasma AGEs level and IMT in the bifurcation of common carotid artery were significantly lower, while plasma NO levels were significantly higher than those in patients with severe CI(P<0.05 or P<0.01). The plasma AGEs levels in patients with CAS were significantly higher than those without CAS, while the plasma NO level was significantly lower than those without CAS(P<0.01). Spearman rank correlation analysis showed that plasma AGEs and IMT in the bifurcation of common carotid artery were positively correlated with the severity of CI, while plasma NO was negatively correlated with the severity of CI. Plasma AGEs level was positively correlated with CAS, while plasma NO level was negatively correlated with CAS. Conclusion Abnormal plasma AGEs and NO levels are associated with the occurrence and development of CI and CAS. The clinical detection of plasma AGEs and NO levels can help understand the progress of CAS, which is of great significance for assessing the severity of CI.
作者
翟云
杨柳
任薇薇
吴金萍
ZHAI Yun;YANG Liu;REN Wei-wei;WU Jin-ping(Department of Geriatrics,Xi'an Union Hospital,Xi'an 710000,China;Department of Outpatient,Hospital of Shanxi Defence Vocational&Technical College,Xi'an 710300,China;Department of Outpatient,Xi'an Northwest Women and Children's Hospital,Xi'an 710061,China;Department of Gynecology,521 Hospital of NORINCO Group,Xi'an 710065,China)
出处
《临床误诊误治》
2020年第2期90-95,共6页
Clinical Misdiagnosis & Mistherapy
基金
陕西省重点研发计划项目(2017CM41135)
关键词
脑梗死
晚期糖基化终产物
一氧化氮
颈动脉内膜中膜厚度
颈动脉粥样硬化
Brain infarction
Advanced glycation end products
Nitric oxide
Carotid intima-media thickness
Carotid atherosclerosis
