摘要
目的 探讨血清内脂素、C1补体肿瘤坏死因子相关蛋白12、半乳糖凝集素-3对2型糖尿病合并脑梗死诊断及预后评估的应用价值。方法 将72例2型糖尿病合并脑梗死患者设为研究组,另选取80例单纯2型糖尿病患者设为对照组。比较入院时两组血清内脂素、C1补体肿瘤坏死因子相关蛋白12、半乳糖凝集素-3水平,采用受试者工作特征曲线分析各血清指标诊断价值,比较治疗7 d及治疗14 d不同预后患者血清内脂素、C1补体肿瘤坏死因子相关蛋白12、半乳糖凝集素-3水平及颈动脉内膜中层厚度,采用Pearson相关性分析法分析各血清指标与颈动脉内膜中层厚度、格拉斯哥预后量表评分关联性及预后预测价值,并采用Kaplan-Meier曲线进行生存分析。结果 入院时研究组血清内脂素、半乳糖凝集素-3水平显著高于对照组(P<0.01),C1补体肿瘤坏死因子相关蛋白12水平显著低于对照组(P<0.01)。血清内脂素、C1补体肿瘤坏死因子相关蛋白12、半乳糖凝集素-3联合诊断2型糖尿病合并脑梗死的曲线下面积最大,为0.878。治疗第7 d、第14 d预后良好组血清内脂素、半乳糖凝集素-3水平及颈动脉内膜中层厚度显著低于入院时(P<0.01),且显著低于预后不良组(P<0.01),C1补体肿瘤坏死因子相关蛋白12水平显著高于入院时(P<0.01),且显著高于预后不良组(P<0.01);治疗第14 d预后不良组血清内脂素及半乳糖凝集素-3水平显著低于入院时(P<0.05或0.01)。血清内脂素、半乳糖凝集素-3水平与颈动脉内膜中层厚度呈显著正相关(P<0.05),C1补体肿瘤坏死因子相关蛋白12水平与颈动脉内膜中层厚度呈显著负相关(P<0.05)。入院第14 d内脂素预测2型糖尿病合并脑梗死预后的曲线下面积最大,为0.808。Kaplan-Meier曲线分析显示,血清内脂素、C1补体肿瘤坏死因子相关蛋白12、半乳糖凝集素-3的生存曲线比较差异有统计学意义(P<0.05或0.01)。结论 2型糖尿病合并脑梗死患者存在血清内脂素、C1补体肿瘤坏死因子相关蛋白12、半乳糖凝集素-3异常表达情况,与颈动脉内膜中层厚度、格拉斯哥预后量表评分关系密切,可作为早期诊断、预后评估的检测指标,为临床治疗指明新方向。
Objective To investigate the application value of serum Visfatin,complement-C1q/tumor necrosis factor-related protein 12(CTRP12)and galectin-3(Gal-3)in the diagnosis and prognosis of type 2 diabetes mellitus(T2DM)complicated with cerebral infarction(CI).Methods Seventy-two patients with T2DM complicated with CI were selected as the study group,and 80 patients with T2DM were selected as the control group.The levels of serumVisfatin,CTRP12 and Gal-3 were compared between the two groups at admission, and the diagnostic value of each serum index was analyzed by the receiver operating characteristic (ROC) curve. The levels of serum Visfatin, CTRP12, Gal-3 and intima-media thickness(IMT) of patients with different prognosis were compared on the 7th and 14th day after treatment. Pearson correlation analysis was used to analyze the correlation between serum indexes and IMT, GOS score and the prognostic value. Kaplan-Meier curve was used for survival analysis. Results The levels of serum Visfatin and Gal-3 in the study group were significantly higher than those in the control group ( P <0.01), and CTRP12 was significantly lower than that in the control group ( P <0.01). The area under curve (AUC) of serum Visfatin, CTRP12 and Gal-3 in the diagnosis of T2DM complicated with CI was the largest, which was 0.878. On the 7th and 14th day of treatment, the levels of serum Visfatin, Gal-3 and IMT in the good prognosis group were significantly lower than those at admission ( P <0.01), and were significantly lower than those in the poor prognosis group ( P <0.01), and the level of CTRP12 was significantly higher than that at admission ( P <0.01), and was significantly higher than that in the poor prognosis group ( P <0.01). On the 14th day of treatment, the levels of serum Visfatin and Gal-3 in the poor prognosis group were significantly lower than those at admission ( P <0.05 or 0.01). Serum Visfatin, Gal-3 levels were significantly positively correlated with IMT ( P <0.05), and CTRP12 levels were significantly negatively correlated with IMT ( P <0 .05). On the 14th day of admission, the AUC of Visfatin in predicting the prognosis of T2DM complicated with CI was the largest, which was 0.808. Kaplan-Meier curve analysis showed that the survival curves of serum Visfatin, CTRP12 and Gal-3 were significantly different ( P <0.05 or 0.01). Conclusions There are abnormal expressions of serum Visfatin, CTRP12 and Gal-3 in patients with T2DM complicated with CI, which are closely related to IMT and GOS scores, and can be used as an indicator for early diagnosis and prognostic evaluation, indicating a new direction for clinical treatment.
作者
李曾一
李星
木亚林
籍胤玺
林玉玲
李杰玉
Li Zengyi;Li Xing;Mu Yalin;Ji Yinxi;Lin Yuling;Li Jieyu(Nanyang Central Hospital,Nanyang 473000,Henan,China)
出处
《临床心身疾病杂志》
CAS
2022年第5期11-18,共8页
Journal of Clinical Psychosomatic Diseases
基金
河南省医学科技攻关计划项目(编号201708234)。
