目的 探讨血清淀粉样蛋白(serum amyloid a protein ,SAA)、视黄醇结合蛋白(retinol binding protein, RBP4)、单核细胞趋化蛋白(monocyte chemotactic protein ,MCP-1)水平变化与缺血性脑卒中患者NIHSS评分的相关性。方法 选取医院2013-01至2015-01诊断为急性缺血性脑卒中的老年住院患者50例为卒中组,另选老年健康体检者50名为对照组,比较两组之间血清MCP-1、SAA、及RBP4水平。根据患者的NIHSS评分标准,将卒中组分为神经功能障碍轻度组、中度组及重度组。比较3组之间血清MCP-1、SAA及RBP4水平,并根据NIHSS评分比较3组间预后恢复、进展性脑卒中率和病死率。结果 卒中组患者血清MCP-1、SAA和RBP4的表达值均高于对照组,差异有统计学意义(P<0.05)。卒中组入院第 3、5、7天的RBP4、MCP-1、SAA较入院第1天明显下降,差异有统计学意义(P＜0.05)。50例患者按NHISS评分分为轻度组12例,中度组18例,重度组20例。中、重度组SAA、RBP4、MCP-4的水平与轻度组比较,差异具有统计学意义(P＜0.05),重度组SAA、RBP4、MCP-4的水平与中度组比较,差异具有统计学意义(P＜0.05)。Logistic回归分析缺血性脑卒中患者卒中预后与血清RBP4、MCP-1、SAA水平呈正相关(P＜0.05)。结论 血清 RBP4、MCP-1、SAA水平也可作为急性缺血性脑卒中判断预后恢复的指标,对其进行检测和干预有助于临床诊断和治疗。

Objective To study the correlations between levels of serum amyloid A protein (SAA), retinol binding protein (RBP4), monocyte chemotactic protein (MCP-1) and the NIHSS score of ischemic stroke patients.Methods Fifty cases of elderly inpatients diagnosed with acute ischemic stroke between January 2013 and January 2015 were selected as the observation group, while another 50 healthy people served as the control group. The serum levels of SAA, RBP4 and MCP-1 were compared between the two groups. According to the NIHSS scores of these patients, the observation group was divided into the mild, moderate and severe groups of neural impairment. Serum levels of MCP-1, SAA and RBP4 were compared between the three groups, so were prognosis, rates of progressive stroke and mortality.Results According to the study, serum MCP-1, SAA and RBP4 levels were higher in the observation group than in the control group, and the difference was statistically significant (P<0.05).Serum MCP-1, SAA and RBP4 levels were gradually increased in the observation group compared with the mild, moderate and severe groups, and the difference was also statistically significant (P<0.05). Serum MCP-9, SAA and RBP4 levels in the observation group were decreased considerably three, five and seven days after hospitalization compared with one day after hospitalization, and the difference was of statistical significance. There were twelve mild cases, eighteen moderate cases and twenty severe cases according to the NIHSS scores. Conclusions Serum, MCP-1, SAA and RBP4 levels of acute ischemic stroke patients are significantly increased and are positively correlated with the severity of the disease, so they can be used as laboratory indicators for the diagnosis of the disease.