摘要
目的 分析脑血栓患者的发病危险因素及脑血栓与血清蛋白激酶C(PKC)、骨硬化蛋白(SOST)、血液流变学指标的相关性.方法 回顾性选择2021年1月至2023年7月唐山市人民医院收治的96例脑血栓患者纳入观察组,另选同期收治的96例非脑血栓者纳入对照组.比较两组一般资料(性别、年龄、体重指数、吸烟、饮酒、高血压、糖尿病、高脂血症、冠心病等)、血清PKC、SOST表达水平及血液流变学指标[血浆黏度(PV)、红细胞压积(HCT)、红细胞聚集指数(RAI)、纤维蛋白原(FIB)];采用多因素Logistic回归分析对脑血栓患者的发病危险因素进行分析;根据美国国立卫生研究院卒中量表(NIHSS)评分将脑血栓患者分为轻度组、中度组和重度组,分析血清PKC、SOST表达水平及血液流变学指标在不同严重程度的脑血栓患者间的差异性;采用Pearson相关性分析对血清PKC、SOST表达水平及血液流变学指标与NIHSS评分、改良RANKIN量表(mRS)评分的关系进行分析.结果 两组性别构成比、年龄、吸烟患者比例、糖尿病患者比例、冠心病患者比例比较,差异均无统计学意义(P＞0.05);观察组的体重指数、饮酒患者比例、高血压患者比例、高脂血症患者比例、血清PKC、SOST水平及PV、HCT、RAI、FIB水平分别为(25.04±1.47)kg/m2、20.83％、54.17％、34.38％、(196.52±45.37)μg/L、(4.65±1.07)ng/mL、(6.75±0.72)mPa·s、(44.82±4.56)％、(5.86±0.71)％、(4.62±0.85)g/L,均高于对照组,差异均有统计学意义(P＜0.05).经多因素Logistic回归分析,高血压、高脂血症、血清PKC、SOST、RAI、FIB均是脑血栓患者发病的独立危险因素(P＜0.05).轻度组、中度组和重度组的血清PKC、SOST表达水平及PV、HCT、RAI、FIB水平比较,差异均有统计学意义(P＜0.05).经Pearson相关性分析,脑血栓患者血清PKC、SOST表达水平及PV、HCT、RAI、FIB水平均与NIHSS评分、mRS评分呈正相关(P＜0.05).结论 脑血栓患者的发病受高血压、高脂血症、血清PKC、SOST、RAI、FIB水平影响,其中血清PKC、SOST及血液流变学指标与其病情严重程度及预后有关.
Abstract
Objective To analyze the risk factors of cerebral thrombosis and the correlation between cerebral thrombosis and serum protein kinase C(PKC),osteosclerosis protein(SOST)and hemorheological indexes.Methods A total of 96 patients with cerebral thrombosis admitted to Tangshan People's Hospital from January 2021 to July 2023 were retrospectively selected as the observation group,and 96 patients without cere-bral thrombosis were selected as the control group.The general data(sex,age,body mass index,smoking,drinking,hypertension,diabetes,hy-perlipidemia,coronary heart disease),the expression levels of PKC and SOST in serum and the hemorheological indices[plasma viscosity(PV),hematopoietic volume(HCT),erythrocyte aggregation index(RAI),fibrinogen(FIB)]of the two groups were compared.The risk factors of pa-tients with cerebral thrombosis were analyzed by multivariate Logistic regression analysis.According to the national institutes of health stroke scale(NIHSS)scores in patients with cerebral thrombosis were divided into mild group,moderate group and severe group.The expression levels of ser-um PKC,SOST expression and hemorheology index difference were analyzed in patients with different severity of cerebral thrombosis.The relation-ship between serum levels of PKC,SOST expression,hemorheology index and NIHSS score and the modified Rankin scale(mRS)score were ana-lyzed by Pearson correlation analysis.Results There were no statistically significant differences in gender composition ratio,age,proportion of smoking patients,proportion of diabetic patients,and proportion of patients with coronary heart disease between the two groups(P＞0.05).The body mass index,proportion of drinking patients,proportion of hypertension patients,proportion of hyperlipidemia patients,serum PKC,SOST levels and PV,HCT,RAI,FIB levels in the observation group were(25.04±1.47)kg/m2,20.83％,54.17％,34.38％,(196.52±45.37)μg/L,(4.65±1.07)ng/mL,(6.75±0.72)mPa·s,(44.82±4.56)％,(5.86±0.71)％,(4.62±0.85)g/L,respectively,which were higher than those of the control group,the differences were statistically significant(P＜0.05).The multivariate Logistic regression analysis shourd that hypertension,hyperlipidemia,serum levels of PKC,SOST,RAI,FIB were independent risk factors for the onset of cerebral thrombosis patients(P＜0.05).There were statistically significant differences in the expression levels of serum PKC and SOST and PV,HCT,RAI,FIB levels among the mild group,moderate group and severe group(P＜0.05).The Pearson correlation analysis,cerebral thrombosis patients serum PKC,SOST expression level and PV,HCT,RAI,FIB are positively correlated with NIHSS score and mRS score(P＜0.05).Conclusion Cerebral thrombosis patients the incidence of hypertension,hyperlipidemia,serum levels of PKC,SOST,RAI,FIB,the serum levels of PKC,SOST and hemorheology index associated with disease severity and prognosis.
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