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目的探讨缺血性卒中(ischemic stroke,IS)患者血清神经元特异性烯醇酶(neuron specific enolase,NSE)增高的相关危险因素。方法从住院患者中纳入85例NSE水平﹥13μg/ml的IS患者,同时随机抽取90例NSE水平不高的IS人群作为对照组。采用免疫透射比浊法检测血清NSE水平。应用非条件Logistic回归分析进行多因素分析。结果单因素分析结果表明:高血压病史、糖尿病史、冠心病史、吸烟史、饮酒史、TG升高、TC升高、LDL-C升高与伴NSE增高的IS患者发生呈正相关(P﹤0.05);HDL-C升高与伴NSE增高的IS患者发生呈负相关(P﹤0.05)。进一步行多因素分析结果表明:高血压病史、糖尿病史是伴NSE增高的IS患者发生的独立危险因素,HDL-C升高是伴NSE增高的IS患者发生的保护因素。结论高血压、糖尿病可以显著促进IS患者NSE水平的增高,增加了IS发生的风险,而HDL-C升高可以抑制NSE水平的升高,对IS的发生起到保护作用。因此对该类人群的相关因素进行必要的干预具有重要的意义。
Objective To investigate the related risk factors of serum neuron specific enolase (NSE) in patients with ischemic stroke (IS). Methods Eighty-five IS patients with NSE level> 13μg / ml were enrolled from hospitalized patients, and 90 IS patients with low NSE level were randomly selected as the control group. Serum NSE levels were measured by immunoturbidimetry. Unconditional logistic regression analysis was used for multivariate analysis. Results The results of univariate analysis showed that the history of hypertension, history of diabetes, history of coronary heart disease, smoking history, drinking history, elevated TG, elevated TC and LDL-C were positively correlated with IS patients with elevated NSE (P < 0.05). The increase of HDL-C was negatively correlated with IS patients with elevated NSE (P <0.05). Further multivariate analysis showed that the history of hypertension and diabetes mellitus were independent risk factors for IS patients with elevated NSE. Elevated HDL-C was a protective factor in IS patients with elevated NSE. Conclusion Hypertension and diabetes mellitus can significantly increase the level of NSE in IS patients and increase the risk of IS. However, elevated HDL-C can inhibit the increase of NSE and play a protective role in the pathogenesis of IS. Therefore, it is of great significance to make the necessary interventions on the relevant factors of such people.