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目的:探讨急性缺血性脑卒中(AIS)患者血清1型纤溶酶原激活物抑制剂(PAI-1)、β淀粉样蛋白(Aβ)水平及其与病情严重程度的相关性。方法:收集2015-03-2016-11我院收治的69例AIS患者(观察组)病例资料,于入院24h内进行美国国立卫生院卒中量表(NIHSS)评分,并进行神经功能缺损程度评分。根据NIHSS评分及神经功能缺损程度评分,将69例观察组患者分为轻型(16例)、中型(44例)、重型(9例)3个亚组,同时收集23例健康体检者为对照组。用ELISA法检测2组血清PAI-1、Aβ水平。观察组血清PAI-1、Aβ水平与神经功能缺损程度评分的Pearson相关分析。结果:观察组血清PAI-1、Aβ水平[(49.34±10.72)mg/L、(176.38±92.46)pg/ml]与对照组[(36.87±8.56)mg/L、(142.25±81.43)pg/ml]比较,差异有统计学意义(P<0.05)。中型组血清PAI-1、Aβ水平[(51.25±9.68)mg/L、(178.47±96.32)pg/ml)]、重型组血清PAI-1、Aβ水平[(55.47±13.43)mg/L、(216.32±117.45)pg/ml]分别与轻型组[(42.54±7.62)mg/L、(152.35±82.56)g/ml]比较,差异均有统计学意义(P<0.05)。重型组血清Aβ水平与中型组比较差异有统计学意义[(216.32±117.45)pg/ml vs.(178.47±96.32)pg/ml,P<0.05]。重型组血清PAI-1水平高于中型组,但差异无统计学意义[(55.47±13.43)mg/L vs.(51.25±9.68)mg/L,P>0.05]。Pearson相关分析显示,血清PAI-1水平与AIS病情严重程度(神经功能缺损程度评分)之间呈正相关(r=0.941,P<0.01)。血清Aβ水平与AIS病情严重程度(神经功能缺损程度评分)之间呈正相关(r=0.882,P<0.01)。结论:AIS患者存在血清PAI-1、Aβ水平升高。Pearson相关分析显示:血清PAI-1、Aβ水平与AIS患者病情严重程度呈正相关,提示血清PAI-1、Aβ水平是AIS病情严重程度的重要指标,可为临床评价AIS病情严重程度提供重要的参考价值。
Objective: To investigate the serum level of PAI-1 and amyloid beta (Aβ) in patients with acute ischemic stroke (AIS) and its relationship with the severity of the disease. Methods: A total of 69 cases of AIS patients (observation group) admitted to our hospital from March 2015 to June 2016 were enrolled. National Institutes of Health Stroke Scale (NIHSS) score and score of neurological deficit were scored within 24h of admission. According to NIHSS score and neurological deficit score, 69 patients in observation group were divided into three groups: light type (16 cases), medium type (44 cases) and heavy type (9 cases). 23 healthy people were also selected as control group . Serum levels of PAI-1 and Aβ were detected by ELISA. Pearson correlation analysis of serum PAI-1, Aβ level and neurological deficit score in observation group. Results: Compared with the control group [(36.87 ± 8.56) mg / L and (142.25 ± 81.43) pg / ml, the PAI-1 and Aβ levels in the observation group were significantly higher than those in the control group [(49.34 ± 10.72) mg / ml], the difference was statistically significant (P <0.05). Serum levels of PAI-1 and Aβ were significantly higher in the severe group (51.25 ± 9.68 mg / L and 178.47 ± 96.32 pg / ml, respectively) than those in the severe group (55.47 ± 13.43 mg / L, 216.32 ± 117.45) pg / ml] were significantly higher than those in the light group [(42.54 ± 7.62) mg / L, (152.35 ± 82.56) g / ml], respectively. The level of Aβ in the severe group was significantly lower than that in the middle group [(216.32 ± 117.45) pg / ml vs. (178.47 ± 96.32) pg / ml, P <0.05]. The levels of serum PAI-1 in severe group were higher than those in medium group, but the difference was not statistically significant [(55.47 ± 13.43) mg / L vs. (51.25 ± 9.68) mg / L, P> 0.05]. Pearson correlation analysis showed that serum PAI-1 level was positively correlated with the severity of AIS (score of neurological deficit) (r = 0.941, P <0.01). There was a positive correlation between serum Aβ level and the severity of AIS (score of neurological deficit) (r = 0.882, P <0.01). Conclusion: Serum PAI-1 and Aβ levels are elevated in AIS patients. Pearson correlation analysis showed that the serum levels of PAI-1 and Aβ were positively correlated with the severity of AIS, suggesting that serum PAI-1 and Aβ levels are important indicators of the severity of AIS and may provide an important reference for clinical evaluation of the severity of AIS value.