摘要
目的探讨急性脑梗死(acute cerebral infarction,ACI)患者血清自噬相关蛋白Beclin-1,巯基丙酮酸硫基转移酶(3-mercaptopyruvate sulfurtransferase,3-MST)和凝血酶敏感蛋白-1(thrombospondin-1,TSP-1)表达水平及与病情和预后的相关性研究。方法选取2019年6月~2021年6月于张家口市第二医院神经内科就诊的ACI患者150例作为研究组,按脑梗死面积大小分为小面积组(71例)、中面积组(42例)和大面积组(37例),按神经损伤程度分为轻度损伤组(75例)、中度损伤组(38例)和重度损伤组(37例),按二个月内生存结局分为存活组(113例)和死亡组(37例)。另选取100例同期体检健康者作为对照组。检测Beclin-1,3-MST和TSP-1在各组研究对象血清中表达水平的变化,分析三者与ACI患者预后的关系。结果研究组患者血清Beclin-1(2.13±0.57 ng/ml),TSP-1(171.45±31.66 ng/ml)水平明显高于对照组(0.88±0.29 ng/ml,86.29±20.52 ng/ml),而3-MST(3.05±0.51 ng/ml)水平明显低于对照组(5.11±0.79 ng/ml),差异均有统计学意义(t=20.234,23.767,25.061,均P<0.001)。血清Beclin-1,TSP-1表达水平大面积组(3.14±0.67 ng/ml,231.91±39.43 ng/ml)高于中面积组(2.15±0.59 ng/ml,201.49±33.19 ng/ml)和小面积组(1.59±0.33 ng/ml,122.17±25.79 ng/ml),中面积组高于小面积组,差异均有统计学意义(F=112.922,171.981,均P<0.001);重度损伤组(3.55±0.51 ng/ml,256.39±37.99 ng/ml)高于中度损伤组(2.29±0.69 ng/ml,203.61±35.97 ng/ml)和轻度损伤组(1.35±0.48 ng/ml,113.25±30.19 ng/ml),中度损伤组高于轻度损伤组,差异均有统计学意义(F=202.342,246.191,均P<0.001);死亡组Beclin-1,TSP-1表达水平(3.15±0.78 ng/ml,277.49±39.55 ng/ml)高于存活组(1.79±0.68 ng/ml,136.73±30.78 ng/ml),差异均有统计学意义(t=10.176,22.433,均P<0.001)。血清3-MST表达水平,大面积组(0.96±0.26 ng/ml)低于中面积组(3.84±0.89 ng/ml)和小面积组(4.67±0.97 ng/ml),中面积组低于小面积组,差异有统计学意义(F=248.483,均P<0.001);重度损伤组(0.84±0.21 ng/ml)低于中损伤组(3.68±0.75 ng/ml)、轻度损伤组(4.65±0.69 ng/ml),中度损伤组低于轻度损伤组,差异有统计学意义(F=461.708,均P<0.001),死亡组低于存活组(2.27±0.75 ng/ml vs 3.31±0.91 ng/ml),差异有统计学意义(t=6.248,P<0.001)。Beclin-1,3-MST和TSP-1预测ACI患者死亡的受试者工作特征曲线(receiver operating characteristic curve,ROC)下面积(area under curve,AUC)分别为0.802,0.649和0.885,三者联合诊断的AUC为0.925,高于三者任一单项指标(均P<0.001)。结论ACI患者血清中Beclin-1,TSP-1表达水平显著升高,3-MST表达水平明显降低,三者与患者脑梗死面积及神经损伤程度密切相关,三者对患者预后具有较高的预测价值,其联合检测有助于患者病情及预后的早期评估。
Objective To investigate the serum autophagy-related protein Beclin-1,3-mercaptopyruvate sulfurtransferase(3-MST)and thrombin sensitive protein-1(TSP-1)expression levels in patients with acute cerebral infarction(ACI)and their correlation with the disease and prognosis.Methods A total of 150 ACI patients admitted to the Department of Neurology of the Second Hospital of Zhangjiakou from June 2019 to June 2021 were selected as the study group.According to the size of cerebral infarction,they were divided into small area group(71 cases),medium area group(42 cases)and large area group(37 cases),and according to the degree of nerve injury,they were divided into mild injury group(75 cases),moderate injury group(38 cases),severe injury group(37 cases),survival group(113 cases)and death group(37 cases)according to the survival outcome within 2 months.Another 100 healthy subjects were selected as the control group.The expression levels of Beclin-1,3-MST and TSP-1 in each group were detected,and the relationship between Beclin-1,3-MST and TSP-1 and prognosis of ACI patients was analyzed.Results The serum levels of Beclin-1(2.13±0.57 ng/ml)and TSP-1(171.45±31.66 ng/ml)in the study group were significantly higher than those in the control group(0.88±0.29 ng/ml,86.29±20.52 ng/ml),the level of 3-MST(3.05±0.51 ng/ml)was significantly lower than that of the control group(5.11±0.79 ng/ml),the differences were statistically significant(t=20.234,23.767,25.061,all P<0.001).The expression levels of Beclin-1 and TSP-1 in large area group(3.14±0.67 ng/ml,231.91±39.43 ng/ml)were higher than those in medium area group(2.15±0.59 ng/ml,201.49±33.19 ng/ml)and small area group(1.59±0.33 ng/ml,122.17±25.79 ng/ml).Medium area group was higher than small area group,the differences were statistically significant(F=112.922,171.981,all P<0.001).The severe injury group(3.55±0.51 ng/ml,256.39±37.99 ng/ml)was higher than the moderate injury group(2.29±0.69 ng/ml,203.61±35.97 ng/ml).The mild injury group(1.35±0.48 ng/ml,113.25±30.19 ng/ml)and the moderate injury group were higher than the mild injury group,the differences were statistically significant(F=202.342,246.191,all P<0.001).The mortality group(3.15±0.78 ng/ml,277.49±39.55 ng/ml)was higher than the survival group(1.79±0.68 ng/ml,136.73±30.78 ng/ml),the differences were statistically significant(t=10.176,22.433,all P<0.001).The serum 3-MST expression level in large area group(0.96±0.26 ng/ml)was lower than that in medium area group(3.84±0.89 ng/ml)and small area group(4.67±0.97 ng/ml),and that in medium area group was lower than that in small area group,the difference was statistically significant(F=248.483,all P<0.001).Severe injury group(0.84±0.21 ng/ml)was lower than moderate injury group(3.68±0.75 ng/ml),mild injury group(4.65±0.69 ng/ml),moderate injury group was lower than mild injury group,the difference was statistically significant(F=461.708,all P<0.001).The mortality group(2.27±0.75 ng/ml)was lower than the survival group(2.27±0.75 ng/ml vs 3.31±0.91 ng/ml),the difference was statistically significant(t=6.248,P<0.001).The area under receiver operating characteristic(ROC)curve area under curve(AUC)of Beclin-1,3-MST and TSP-1 in predicting death in ACI patients were 0.802,0.649 and 0.885,respectively.The AUC of the combined diagnosis of Beclin-1,3-MST and TSP-1 was 0.925,higher than any single index of the three(all P<0.001).Conclusion The levels of Beclin-1 and TSP-1 in serum of ACI patients significantly increased,while the level of 3-MST significantly decreased.The three were closely related to the size of cerebral infarction and the degree of nerve injury in patients,and the three had high prognostic value for patients,and the combined detection of the three was helpful for the early evaluation of patients’condition and prognosis.
作者
张磊
赵腾跃
李彬
ZHANG Lei;ZHAO Teng-yue;LI Bin(Department of Neurology,the Second Hospital of Zhangjiakou City,Hebei Zhangjiakou 075000,China;Department of Neurology,Baoding Cerebrovascular Disease Hospital,Hebei Baoding 071000,China)
出处
《现代检验医学杂志》
CAS
2022年第6期124-128,148,共6页
Journal of Modern Laboratory Medicine
基金
保定市科技计划项目(2041ZF281)。
