【摘要】 目的:探讨老年H型高血压合并急性缺血性脑卒中患者血清网膜素-1(omentin-1)、鸢尾素(Irisin)水平与病情及预后的关系。方法:选择2017年6月-2019年9月我院收治的老年H型高血压合并急性缺血性脑卒中患者92例,记作合并脑卒中组,根据美国国立卫生研究院卒中量表(NIHSS)评分将患者分为轻症组28例(NIHSS评分≤4分)、中症组39例(5分≤NIHSS评分≤20分)和重症组25例(NIHSS评分>20分),根据改良Rankin量表(mRS)评分将患者分为预后不良组28例(mRS评分>2分)和预后良好组64例(m RS评分≤2分)。另选择同期我院收治的单纯老年H型高血压患者90例作为单纯H型高血压组,分析合并脑卒中组患者血清omentin-1、Irisin水平及omentin-1、Irisin与NIHSS评分、m RS评分的相关性,并应用ROC曲线分析血清omentin-1、Irisin水平对患者预后的预测价值。结果:合并脑卒中组血清omentin-1、Irisin水平显著低于单纯H型高血压组(P<0.05),随脑卒中神经缺损严重程度的升高,H型高血压合并急性缺血性脑卒中患者血清omentin-1、Irisin水平逐渐降低(P<0.05),预后不良组血清omentin-1、Irisin水平显著低于预后良好组(P<0.05)。老年H型高血压合并急性缺血性脑卒中患者血清omentin-1、Irisin水平与NIHSS评分及m RS评分均呈负相关(P<0.05)。omentin-1最佳临界值为105.36 ng/ml,敏感度为78.23%,特异度为83.44%;Irisin最佳临界值为90.77 ng/L,敏感度为71.00%,特异度为61.43%。结论:老年H型高血压合并急性缺血性脑卒中患者血清omentin-1、Irisin水平异常降低,其水平与神经缺损程度和预后呈负相关,血清omentin-1、Irisin对老年H型高血压发生急性缺血性脑卒中的预后评估具有一定价值。更多还原

【Abstract】 Objective: To investigate the relationship between the serum levels of omentin-1(omentin-1),irisin(Irisin)and the prognosis in elderly patients with H-type hypertension and acute ischemic stroke. Methods: 92 elderly patients with H-type hypertension and acute ischemic stroke who were treated in our hospital from June 2017 to September 2019 were selected, it was recorded as combined with stroke group, according to national Institutes of Health Stroke Scale(NIHSS) score, the patients were divided into mild group(28 cases, NIHSS score ≤4 points), moderate group(39 cases, 5 points ≤NIHSS score ≤20 points) and severe group(25 cases, NIHSS score > 20 points). According to the modified Rankin Scale(MRS) score, the patients were divided into two groups: 28 patients with poor prognosis(MRS score > 2 points) and 64 patients with good prognosis(MRS score ≤2 points). In addition, 90 elderly patients with H-type hypertension admitted to our hospital in the same period were selected as the H type hypertension group. To analyze the level of serum omentin-1, irisin and the correlation between omentin-1, irisin and NIHSS score, Mrs score in patients with stroke. ROC curve was used to analyze the prognostic value of serum omentin-1 and irisin levels. Results: The serum levels of omentin-1 and irisin in the patients with stroke were significantly lower than those in the patients with simple H-type hypertension(P<0.05). With the increase of the severity of neurological deficit in stroke, the serum levels of omentin-1 and irisin in the patients with H-type hypertension and acute ischemic stroke decreased gradually(P<0.05). The serum levels of omentin-1 and irisin in the patients with poor prognosis were significantly lower than those in the patients with good prognosis(P<0.05). The levels of serum omentin-1 and irisin were negatively correlated with NIHSS and MRS in elderly patients with H-type hypertension and acute ischemic stroke(P<0.05). The optimal critical value of omentin-1 was 105.36 ng/mL, the sensitivity was 78.23%, and the specificity was 83.44%; the optimal critical value of irisin was 90.77 ng/L, the sensitivity was 71.00%, and the specificity was 61.43%. Conclusion: The serum levels of omentin-1 and irisin in the elderly patients with H-type hypertension and acute ischemic stroke decreased abnormally, which were negatively related to the degree of nerve defect and prognosis. The serum levels of omentin-1 and irisin have a certain value for the prognosis evaluation of the elderly patients with H-type hypertension and acute ischemic stroke.更多还原