摘要
目的探讨外周血尿酸(UA)、γ谷氨酰转移酶(GGT)和甲壳质酶蛋白40(YKL-40)水平与急性脑梗死患者短期预后的关系。方法选取2020年12月至2024年12月界首市人民医院收治的200例急性脑梗死患者作为脑梗死组,另选取同期150例健康志愿者作为健康组。比较两组一般临床资料以及外周血UA、GGT及YKL-40水平,采用Pearson相关性分析外周血UA、GGT及YKL-40水平与白蛋白、白细胞计数、中性粒细胞、纤维蛋白降解产物、梗死部位相关性。根据急性脑梗死患者发病30 d后预后情况分为预后不良组(62例)和预后良好组(138例),比较两组外周血UA、GGT及YKL-40水平,采用多因素Logistic回归分析急性脑梗死患者短期预后不良的影响因素,通过ROC曲线评估外周血UA、GGT及YKL-40水平对急性脑梗死患者短期预后的预测价值。结果脑梗死组白细胞计数、中性粒细胞、纤维蛋白降解产物水平高于健康组,白蛋白水平低于健康组,差异有统计学意义(P<0.05)。脑梗死组外周血UA、GGT及YKL-40水平高于健康组[(350.24±62.19)μmol/L vs(275.42±50.28)μmol/L、(54.82±12.27)U/L vs(32.02±7.01)U/L、(34.05±7.68)ng/mL vs(24.05±3.53)ng/mL,P<0.05]。外周血UA、GGT及YKL-40水平与白细胞计数、中性粒细胞、纤维蛋白降解产物均呈显著正相关,与白蛋白呈显著负相关(P<0.05)。预后不良组外周血UA、GGT及YKL-40水平高于预后良好组[(380.34±60.39)μmol/L vs(336.72±63.45)μmol/L、(58.93±10.56)U/L vs(52.97±12.73)U/L、(37.41±6.89)ng/mL vs(32.54±7.07)ng/mL,P<0.05]。多因素Logistic回归分析结果显示,外周血UA、GGT及YKL-40水平与急性脑梗死患者短期预后相关(OR=1.028,95%CI:1.016~1.041,P<0.001;OR=1.014,95%CI:1.002~1.026,P=0.020;OR=1.115,95%CI:1.005~1.237,P=0.040)。联合检测预测急性脑梗死患者短期预后的AUC为0.823,优于UA、GGT及YKL-40单独检测的0.727、0.654、0.691(Z=3.311、3.876、3.652,P<0.05)。结论急性脑梗死患者外周血UA、GGT及YKL-40水平显著高于健康人群,且外周血UA、GGT及YKL-40水平异常升高可预测急性脑梗死患者短期不良预后,三者联合检测价值更高,提示其可能参与急性脑梗死疾病发生与进展。
Objective To investigate the relationship between peripheral blood uric acid(UA),gamma glutamyl transferase(GGT)and chitinase-3-like protein 1(YKL-40)levels and short-term prognosis in patients with acute cerebral infarction.Methods A total of 200 patients with acute cerebral infarction admitted to Jieshou People's Hospital from December 2020 to December 2024 were selected as the cerebral infarction group,and 150 healthy volunteers were enrolled as the healthy group.The general clinical data and peripheral blood UA,GGT,and YKL-40 levels were compared.Pearson's correlation analysis was used to analyze the correlation between peripheral blood UA,GGT,YKL-40 levels and albumin,white blood cell count,neutrophils,fibrin degradation products,and infarct site.Patients were divided into a poor prognosis group(62 cases)and a good prognosis group(138 cases)based on 30-day post-onset outcomes.Their peripheral blood UA,GGT,and YKL-40 levels were compared.Multivariate Logistic regression identified factors influencing poor short-term prognosis,and the predictive value of UA,GGT,and YKL-40 was evaluated using the ROC curve.Results The white blood cell count,neutrophil,and fibrin degradation products in the cerebral infarction group were higher than those in the healthy group,while albumin was lower,with statistically significant differences(P<0.05).Peripheral blood UA,GGT,and YKL-40 levels were higher in the cerebral infarction group than in the healthy group[(350.24±62.19)μmol/L vs(275.42±50.28)μmol/L,(54.82±12.27)U/L vs(32.02±7.01)U/L,(34.05±7.68)ng/mL vs(24.05±3.53)ng/mL,P<0.05].Peripheral blood UA,GGT,and YKL-40 levels were significantly positively correlated with white blood cell count,neutrophil,and fibrin degradation products,and significantly negatively correlated with albumin(P<0.05).Peripheral blood UA,GGT,and YKL-40 levels in the poor prognosis group were significantly higher than those in the good prognosis group[(380.34±60.39)μmol/L vs(336.72±63.45)μmol/L,(58.93±10.56)U/L vs(52.97±12.73)U/L,(37.41±6.89)ng/mL vs(32.54±7.07)ng/mL,P<0.05].Multivariate Logistic regression analysis showed that peripheral blood UA,GGT,and YKL-40 levels were associated with short-term prognosis in acute cerebral infarction patients(OR=1.028,95%CI:1.016-1.041,P<0.001;OR=1.014,95%CI:1.002-1.026,P=0.020;OR=1.115,95%CI:1.005-1.237,P=0.040).The AUC of combined detection for predicting short-term prognosis was 0.823,significantly higher than that of UA(0.727),GGT(0.654),and YKL-40(0.691)alone(Z=3.311,3.876,3.652,P<0.05).Conclusion Peripheral blood UA,GGT,and YKL-40 levels in acute cerebral infarction patients were significantly higher than those in healthy individuals.Moreover,abnormally elevated levels of these markers could predict short-term poor prognosis in acute cerebral infarction patients,with combined detection offering superior predictive value.This suggests their potential involvement in the pathogenesis and progression of acute cerebral infarction.
作者
闫玉英
张秋侠
刘勇
李宇航
王敏
YAN Yuying;ZHANG Qiuxia;LIU Yong;LI Yuhang;WANG Min(Department of Neurology,Jieshou People's Hospital,Jieshou,Anhui 236500,China)
出处
《转化医学杂志》
2025年第7期52-57,共6页
Translational Medicine Journal
基金
安徽省卫生健康科研项目(AHWJ2022b093)。
关键词
急性脑梗死
尿酸
Γ谷氨酰转移酶
甲壳质酶蛋白40
Acute cerebral infarction
Uric acid
Gamma glutamyl transferase
Chitinase protein 40
