PTX3 expression in the plasma of elderly ACI patients and its relationship with severity and prognosis of the disease.
PTX3 expression in the plasma of elderly ACI patients and its relationship with severity and prognosis of the disease.
复制标题
老年ACI患者血浆中PTX3的表达及其与疾病严重程度和预后的关系
DOI：
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发表时间：
2016
影响因子：
3.3
通讯作者：
J
中科院分区：
文献类型：
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作者：
L. Qin;W. Li;Y. Huang;F. Lu;S;H. Yang;J
目的
本研究旨在探讨正五聚蛋白3（pentraxin 3，PTX 3）在老年急性脑梗死（acute cerebral infarction，ACI）患者中的表达，并分析PTX 3与ACI严重程度及预后的关系。
患者和方法
2014年6月至2015年8月期间，96例首次发作ACI的老年患者被纳入本研究。另外，70名健康老年受试者被纳入本研究作为对照。分别于治疗前及治疗后30 d测定血浆PTX 3、C反应蛋白（CRP）、肿瘤坏死因子（TNF）-α、同型半胱氨酸（Hcy）、纤维蛋白原（FIB）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）水平。采用美国国立卫生研究院卒中量表（NIHSS）评估ACI的严重程度，采用改良兰金量表（mRS）评估预后。比较各组间上述指标水平的差异，并探讨PTX 3与上述生化指标及评分的关系。
结果
急性脑梗死患者血浆PTX 3水平显著高于健康对照组（p < 0.05）。与低分组相比，高分组mRS及除Hcy、HDL-C外的其他各项指标均显著升高。此外，高评分组患者血浆HDL-C水平显著低于低评分组（p < 0.05）。高浓度组患者的生化指标、NIHSS评分和mRS评分均显著高于低浓度组（p < 0.05），而血浆HDL-C水平两组间差异无显著性（p > 0.05）。预后良好组患者的NIHSS评分和除HDL-C外的所有生化指标水平均明显低于预后不良组患者。预后良好组HDL-C水平明显高于预后不良组（p < 0.05）。PTX 3水平分别与CRP、TNF-α、Hcy、TC、TG、LDL-C水平、NIHSS评分、mRS评分呈正相关，（r = 0.814、0.682、0.704、0.726、0.699、0.734、0.746、0.753，p = 0.008、0.043、0.034、0.027、0.036、0.024、0.021、0.019）。然而，FIB水平与HDL-C水平之间未观察到显著相关性（r = 0.326，0.626，p = 0.392，0.071）。
结论
PTX 3的血浆水平在老年ACI患者中显著升高，并且该水平沿着疾病的加重和预后的恶化而升高。此外，PTX 3水平与炎症标志物和脂质水平呈正相关。因此，PTX 3可作为预测和评估老年ACI患者临床状况的生物标志物。
OBJECTIVE
This study aims to investigate the expression of pentraxin3 (PTX3) in elderly patients with acute cerebral infarction (ACI) and to analyze the relationship of PTX3 with the severity and prognosis of ACI.
PATIENTS AND METHODS
Between June 2014 and August 2015, 96 elderly patients with first-onset of ACI admitted to our institution were enrolled in the present study. Also, 70 healthy elderly subjects were included as controls in this study. Levels of PTX3, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, homocysteine (Hcy), fibrinogen (FIB), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined in all patients both pre-therapeutically and 30 days post-therapeutically. Moreover, the severity of ACI was evaluated using the National Institute of Health stroke scale (NIHSS), and the prognosis was evaluated using the Modified Rankin Scale (mRS). The differences in the levels of above parameters were compared between groups, and the relationship between PTX3 and above biochemical parameters as well as the scores were investigated.
RESULTS
PTX3 levels in the plasma of ACI patients were significantly higher than those of healthy controls (p < 0.05). Compared to low score group, mRS and levels of all parameters except Hcy and HDL-C were significantly increased in the patients of the high score group. In addition, plasma levels of HDL-C in the patients of the high score group were significantly lower than those in the low score group (p < 0.05). Biochemical parameters, NIHSS scores and mRS scores were significantly higher in the patients of the high concentration group than the low concentration group (p < 0.05), while no significant differences were observed in the plasma HDL-C levels between these two groups (p > 0.05). NIHSS scores and levels of all the biochemical parameters except HDL-C were significantly lower in the patients of the good prognosis group than in the patients of the poor prognosis group. HDL-C levels were significantly higher in the good prognosis group than in the poor prognosis group (p < 0.05). PTX3 levels were positively correlated with levels of CRP, TNF-α, Hcy, TC, TG and LDL-C as well as NIHSS score and mRS score, respectively, (r = 0.814, 0.682, 0.704, 0.726, 0.699, 0.734, 0.746, 0.753, p = 0.008, 0.043, 0.034, 0.027, 0.036, 0.024, 0.021, 0.019). However, no significant correlations were observed between FIB levels and HDL-C levels (r = 0.326, 0.626, p = 0.392, 0.071).
CONCLUSIONS
Plasma levels of PTX3 are significantly elevated in elderly ACI patients, and the levels increase along with the exacerbation of the disease and deterioration in the prognosis. Also, PTX3 levels are positively correlated with levels of inflammatory markers as well as lipids. Therefore, PTX3 can be used as a biomarker for predicting and evaluating clinical conditions of ACI in elderly patients.