摘要
目的探讨血清激肽释放酶6(KLK6)、α-突触核蛋白(α-syn)预测缺血性脑卒中后认知功能障碍(iPSCI)的临床价值。方法回顾性选取2020年1月至2024年6月咸阳市第一人民医院收治的196例缺血性脑卒中患者,其中72例发生iPSCI(认知障碍组),124例认知功能正常(认知正常组)。比较两组患者入院时血清KLK6、α-syn水平及基线资料。绘制受试者工作特征(ROC)曲线评价血清KLK6、α-syn及二者联合对iPSCI的预测价值,采用多因素Logistic逐步回归分析探讨iPSCI的影响因素。结果认知障碍组血清KLK6、α-syn水平均高于认知正常组(P<0.05)。血清KLK6、α-syn及联合预测iPSCI的AUC(95%CI)分别为0.843(0.793~0.893)、0.716(0.671~0.766)、0.922(0.877~0.972)。多因素分析显示:吸烟史(OR=2.042,95%CI:1.117~3.735)、合并高血压(OR=2.354,95%CI:1.190~4.656)、入院时NIHSS评分(OR=2.841,95%CI:1.384~5.832)、血清KLK6(OR=3.777,95%CI:1.963~7.269),血清α-syn(OR=3.111,95%CI:1.840~5.261)是iPSCI的独立危险因素(P<0.05)。结论入院时血清KLK6、α-syn水平与iPSCI发生显著相关,二者联合检测具有较高的预测价值,可作为早期识别iPSCI高危患者的潜在生物学标志物。
Objective To explore the clinical value of serum kallikrein 6(KLK6)andα-synuclein(α-syn)in predicting cognitive dysfunction after ischemic stroke(iPSCI).Methods A retrospective selection was made of 196 patients with ischemic stroke admitted to the First People's Hospital of Xianyang from January 2020 to June 2024,among whom 72 cases developed iPSCI(cognitive impairment group)and 124 cases had normal cognitive function(cognitive normal group).The levels of serum KLK6 andα-syn and baseline data at admission of the two groups at admission were compared.The receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of serum KLK6,α-syn and their combination for iPSCI.The influencing factors of iPSCI were explored by multivariate Logistic stepwise regression analysis.Results The levels of serum KLK6 andα-syn in the cognitive impairment group were higher than those in the cognitive normal group(P<0.05).The AUC(95%CI)of serum KLK6,α-syn and their combination for predicting iPSCI were 0.843(0.793-0.893),0.716(0.671-0.766),and 0.922(0.877-0.972),respectively.Multivariate analysis showed that smoking history(OR=2.042,95%CI:1.117-3.735),hypertension(OR=2.354,95%CI:1.190-4.656),NIHSS score at admission(OR=2.841,95%CI:1.384-5.832),serum KLK6 level(OR=3.777,95%CI:1.963-7.269),and serumα-syn level(OR=3.111,95%CI:1.840-5.261)were independent risk factors for iPSCI(P<0.05).Conclusion The levels of serum KLK6 andα-syn at admission are significantly correlated with the occurrence of iPSCI.The combined detection of the two has a high predictive value and can be used as potential biomarkers for the early identification of high-risk patients with iPSCI.
作者
吴雅欣
鱼丽萍
孔维
陈鹏
潘欢
赵锦华
WU Yaxin;YU Liping;KONG Wei;CHEN Peng;PAN Huan;ZHAO Jinhua(Department of Neurology,Xianyang First People's Hospital,Xianyang,Shaanxi 712000,China)
出处
《转化医学杂志》
2025年第7期69-73,共5页
Translational Medicine Journal
基金
陕西省自然科学基础研究计划项目(2020JQ-928)。
