摘要
目的 探讨血清血红素氧合酶1(HO-1)、糖原合成酶激酶-3β(GSK-3β)与脑梗死(CI)患者病情严重程度及预后的关系。方法 选择2022年1月至2024年4月该院收治的185例CI患者纳入CI组,根据美国国立卫生研究院卒中量表(NIHSS)评分,将患者分为轻度组(59例)、中度组(84例)、重度组(42例),根据患者预后症状,将CI患者分为预后良好组、预后不良组。另选取同期185例体检健康者作为对照组。采用酶联免疫吸附试验检测血清HO-1、GSK-3β水平;采用多因素Logistic回归分析CI患者预后不良的影响因素;采用受试者工作特征(ROC)曲线分析血清HO-1、GSK-3β对CI患者预后不良的预测效能。结果 与对照组相比,CI组血清HO-1水平降低(P<0.05),GSK-3β水平升高(P<0.05)。轻度组、中度组、重度组CI患者血清HO-1水平依次降低,血清GSK-3β水平依次升高,任意2组间比较差异均有统计学意义(P<0.05)。与预后良好组比较,预后不良组梗死灶最大径、血清GSK-3β水平显著升高(P<0.05),血清清蛋白、HO-1水平显著降低(P<0.05);HO-1水平升高是CI患者预后不良的独立保护因素(P<0.05),GSK-3β水平升高是CI患者预后不良的独立危险因素(P<0.05)。血清HO-1、GSK-3β单独预测CI患者预后不良的曲线下面积(AUC)分别为0.841、0.793,而二者联合预测的AUC为0.912,预测效能更优(Z_(HO-1-二者联合)=3.235、Z_(GSK-3β-二者联合)=3.154,均P<0.05)。结论 CI患者血清HO-1水平降低,GSK-3β水平升高,二者与CI患者病情严重程度密切相关,且联合检测对CI患者预后有较高的预测效能。
Objective To investigate the association of serum heme oxygenase-1(HO-1)and glycogen synthase kinase-3β(GSK-3β)levels with disease severity and prognosis in patients with cerebral infarction(CI).Methods A total of 185 patients with CI admitted to this hospital from January 2022 to April 2024 were selected as the CI group.Based on the National Institutes of Health Stroke Scale(NIHSS)scores,the patients were divided into mild group(59 cases),moderate group(84 cases)and severe group(42 cases).According to the prognosis symptoms of the patients,the CI patients were divided into good prognosis group and poor prognosis group.In addition,185 healthy individuals who underwent physical examination during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to detect serum HO-1 and GSK-3βlevels;multivariate Logistic regression analysis was used to analyze the factors affecting the prognosis of CI;receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of serum HO-1 and GSK-3βfor the prognosis of CI.Results Compared with the control group,serum HO-1 level was significantly lower(P<0.05),and GSK-3βlevel was significantly higher(P<0.05)in the CI group.Serum HO-1 level was decreased sequentially in the mild,moderate and severe groups of CI patients,while serum GSK-3βlevel was increased sequentially,with statistically significant differences between any two groups(P<0.05).The maximum diameter of infarct lesions and serum GSK-3βlevel were significantly increased in the poor prognosis group compared with those in the good prognosis group(P<0.05),while serum albumin(Alb)and HO-1 levels were significantly decreased(P<0.05).Elevated HO-1 level was identified as an independent protective factor for poor prognosis in CI patients(P<0.05),whereas elevated GSK-3βlevel was an independent risk factor(P<0.05).The areas under the curve(AUC)for serum HO-1 and GSK-3βalone in predicting CI prognosis were 0.841 and 0.793 respectively.The combined prediction of both markers yielded an AUC of 0.912,indicating superior predictive efficacy(Z_(HO-1 vs.combination)=3.235,Z_(GSK-3βvs.combination)=3.154,both P<0.05).Conclusion Serum HO-1 level is decreased while GSK-3βlevel is elevated in patients with CI.Both biomarkers are closely associated with the severity of the condition,and their combined detection demonstrates high predictive value for the prognosis of CI.
作者
周婕
王瑶
谭鑫
ZHOU Jie;WANG Yao;TAN Xin(Department of Neurology,the Third People′s Hospital of Chengdu,Sichuan,Chengdu 610000,China)
出处
《检验医学与临床》
2025年第24期3416-3421,共6页
Laboratory Medicine and Clinic
