簇集蛋白在急性脑梗死中的表达及其临床意义

摘要

目的：探讨簇集蛋白（CLU）在急性脑梗死（ACI）中的表达及其临床意义。方法选取2013年5～12月于南昌大学第一附属医院住院（首次发病48 h内）的ACI患者154例作为ACI组，根据神经功能缺损程度、有无斑块进行亚分组，另选取45例同期体检健康者作为对照组，检测血清CLU、补体C3水平，进行美国国立卫生院神经功能缺损评分（NIHSS）及Barthel指数评定，随访康复经过及结局至发病后90 d ，比较分析血清CLU 水平。结果 ACI组患者血清CLU、补体C3水平均较对照组增高，差异均有统计学意义（P＜0．01），且ACI患者血清CLU与补体C3水平呈正相关（r＝0．430，P＝0．000）。有斑块、神经功能缺损程度重的患者血清CLU水平高于无斑块、神经功能缺损程度轻的患者，差异均有统计学意义（P＜0．01或 P＜0．05）。除痊愈与显效患者血清CLU水平比较差异无统计学意义（P＞0．05），其余各预后类型患者血清CLU水平比较，差异均有统计学意义（P＜0．01或 P＜0．05），血清CLU水平越低患者康复情况越好。结论 CLU 在脑梗死发生后可调节补体系统发挥作用，血清CLU水平与ACI患者颈动脉斑块、神经功能缺损程度及预后均相关，可作为ACI患者病情评估及指导预后的生化指标之一。%Objective To investigate the expression and clinical significance of clusterin (CLU ) in acute cerebral infarction (ACI) .Methods A total of 154 inpatients with ACI within 48 h of the first onset in the First Affiliated Hospital of Nanchang Uni‐versity from May to December 2013 served as the ACI group and divided into subgroups according to the neural function defection degree and whether having plaque .Contemporaneous 45 individuals undergoing the healthy physical examination were selected as the control group .The serum CLU and complement C3 levels were detected .The National Institutes of Health Stroke Scale (NIH‐SS) and Barthel index scores were conducted ,the rehabilitation course and outcome until 90 d after onset were followed up ,and the comparative analysis on serum CLU level was performed .Results The serum CLU and complement C3 levels in the ACI group were significantly higher than those in the control group ,the differences were statistically significant (P<0 .01) ,moreover serum CLU was positively correlated with the complement C3 level in ACI patients(r=0 .430 ,P=0 .000) .The CLU level in the patients with plaque and severe neural function defection was higher than that in the patients without plaque and mild neural function defec‐tion ,the differences were statistically significant (P<0 .01 or P<0 .05) .Except serum CLU level had no statistical difference be‐tween the recovery group and significantly effective group (P>0 .05) ,the serum CLU level had statistically significant differences among other prognosis types of the patients groups (P<0 .01 or P<0 .05) .The lower the serum CLU level ,the rehabilitation the better .Conclusion CLU play a role by regulating the complement system after cerebral infarction occurrence ,serum CLU level is correlated with carotid arterial plaque ,neurological function defection degree and prognosis in ACI patients ,which can serve as one of biochemical indicators for evaluating the disease condition and guiding prognosis in ACI patients .