急性缺血性脑卒中患者血清钙调蛋白水平与脑梗死面积、NIHSS评分的关系

摘要

Objective To observe the relationship between the value of calmodulin obtained in pa-tients with acute ischemic stroke with the NIHSS score and with the infarction size. Try to find whether the val-ue of calmodulin are positively correlated with acute illness severity. Methods The serum CAM value were compared in 136 patients with acute IS and 136 normal controls. According Adamas taxonomy 136 cases of pa-tients were divided into large infarction group(33),a small infarction group(45),lacunar infarction(58)three subgroups,and according to the U. S National Institutes of Health Stroke Scale(NIHSS)score these patients were divided into the NIHSS score>5 group(59)and NIHSS score≤5 group(77)two subgroups. Respectively compared the relationship between CAM value of acute IS patients with the NIHSS score and with the area of cerebral infarction. Results The serum calmodulin level of IS group had more statistically significantwas than normal control group(t=14. 48,P<0. 001);There was a significant difference in the CAM values on different NIHSS score group(t=11. 54,P<0. 001);There was a significant difference in the CAM value on different infarction area groups(F= 256. 74,P<0. 001). Furtherly by Pearson correlation analysis showed that the ser-um of CAM value in patients with aute IS was positively correlated not only with the NIHSS score and the in-farct size. Conclusion The serum CAM value obtained in patients with acute IS were positively correlated with the NIHSS score and the infarct size,It can be used as an important indicator of IS patients with acute disease severity.%目的：研究急性缺血性脑卒中( IS)患者钙调蛋白( CAM)水平与脑梗死面积、NIHSS评分的关系。探讨CAM值与急性期病情是否呈正相关。方法2012年6月~2014年12月海军总医院急诊科将136例急性IS患者作为观察组,与来院进行体检的136例健康人群作为对照组进行血清CAM值比较,并将观察组患者依据Adamas分类法分为三个亚组：大梗死组(33例)、小梗死组(45例)、腔隙性脑梗死(58例),按NIHSS评分分为NIHSS评分>5分组(59例)和NIHSS评分≤5分组(77例)两个亚组。分别比较CAM值、NIHSS评分、脑梗死面积。结果观察组患者血清CAM值(188．69±25．25),对照组(87．8±74．12)比较有统计学意义(t=14．48,P<0．001)；IHSS评分>5分组CAM(239．21±59．01),NIHSS评分≤5分组(138．33±54．17),不同NIHSS评分组间患者血清CAM值比较有显著差异(t=11．54,P<0．001)；大梗死组CAM(281．17±51．46),小梗死组CAM(188．65±16．13),腔隙性脑梗死组CAM(128．37±14．40),不同脑梗死面积组CAM值比较有显著差异(F=256．74,P<0．001)。进一步经Pearson相关分析发现IS患者血清CAM值与NIHSS评分呈正相关(r=0．318,P<0．005),与梗死面积均呈正相关(r=0．569,P<0．05)。结论血清CAM值与NIHSS评分、脑梗死面积呈正相关,可作为一重要指标反映IS患者急性期病情的严重性。