摘要
目的探究急性缺血性脑卒中(AIS)患者血清凝集蛋白-1(ITLN-1)、前蛋白转化酶枯草溶菌素9(PCSK9)水平及其与患者病情、预后的关系。方法选取2021年1月至2024年1月邢台医专第二附属医院收治的169例AIS患者作为AIS组,依据病情分为A组(54例轻度)、B组(70例中度)和C组(45例重度),出院3个月后,依据改良Rankin量表(mRS)评分评估患者预后,分为良好组(127例)和不良组(42例)。同期选择160例健康体检者作为健康组。采用酶联免疫吸附法检测血清ITLN-1、PCSK9水平,比较AIS组与健康组血清ITLN-1、PCSK9水平,比较不同病情患者血清ITLN-1、PCSK9水平,比较不同预后AIS患者资料及血清ITLN-1、PCSK9水平,多因素logistic回归分析AIS患者预后不良的影响因素,受试者工作特征曲线分析血清ITLN-1、PCSK9水平对AIS患者预后不良的诊断价值。结果与健康组比较,AIS组血清ITLN-1水平降低,血清PCSK9水平升高(P<0.05);随着AIS患者病情加重,AIS患者血清ITLN-1水平降低,血清PCSK9水平升高(P<0.05);与预后良好组比较,预后不良组入院美国国立卫生研究院卒中量表(NIHSS)评分、血清PCSK9及C反应蛋白(CRP)水平升高,血清ITLN-1水平降低(P<0.05);logistic回归分析发现,入院时NIHSS评分及血清ITLN-1、PCSK9水平是AIS患者预后不良的影响因素(P<0.05);血清ITLN-1、PCSK9水平联合诊断AIS患者预后不良的曲线下面积(AUC)高于ITLN-1水平单独诊断的AUC(Z=2.408,P=0.016),高于PCSK9水平单独诊断的AUC(Z=3.191,P=0.001)。结论AIS患者血清ITLN-1水平降低,血清PCSK9水平升高,可用于患者病情及预后评估。
Objective To investigate the serum levels of intelectin-1(ITLN-1)and proprotein convertase subtilisin/kexin type 9(PCSK9)in patients with acute ischemic stroke(AIS)and their relationship with the disease condition and prognosis of patients.Methods A total of 169 patients with acute intestinal strangulation(AIS)admitted to the Second Affiliated Hospital of Xingtai Medical College from January 2021 to January 2024 were selected to form the AIS group.Based on disease severity,they were categorized into Group A(54 mild cases),Group B(70 moderate cases),and Group C(45 severe cases)..Three months after discharge,the patients were assessed for prognosis using the modified Rankin Scale(mRS)and divided into a good group(127 cases)and a poor group(42 cases).At the same time,160 healthy individuals undergoing physical examinations were selected as the healthy group.Enzyme-linked immunosorbent assay was used to detect serum ITLN-1 and PCSK9 levels.Serum ITLN-1 and PCSK9 levels between the AIS group and the healthy group were compared.The serum levels of ITLN-1 and PCSK9 were compared among different disease condition.The data and the serum levels of ITLN-1 and PCSK9 were compared among different prognosis.Multivariate logistic regression was used to analyze the influencing factors of poor prognosis in AIS patients.ROC was used to analyze the diagnostic value of serum ITLN-1 and PCSK9 levels for poor prognosis of AIS patients.Results Compared with the healthy group,the AIS group showed a decrease in serum ITLN-1 level and an increase in serum PCSK9 level(P<0.05).With the aggravation of AIS patients,the serum ITLN-1 level and the serum PCSK9 level increased(P<0.05).Compared with the group with favorable prognosis,the group with unfavorable prognosis exhibited elevated NIHSS scores at admission,increased serum PCSK9 and C-reactive protein(CRP)levels,and decreased serum ITLN-1 levels(P<0.05).Logistic regression analysis revealed that NIHSS scores at admission and serum levels of IL-1βand PCSK9 are factors associated with poor prognosis in AIS patients(P<0.05).AUC for the combined diagnosis of poor prognosis in AIS patients using serum ITLN-1 and PCSK9 levels was higher than the AUC for the diagnosis using ITLN-1 levels alone(Z=2.408,P=0.016)and higher than the AUC for the diagnosis using PCSK9 levels alone(Z=3.191,P=0.001).Conclusion The serum ITLN-1 level decreases and the serum PCSK9 level increases in AIS patients,which can be used for evaluating the disease condition and prognosis.
作者
郭丹丹
贾吟玉
张钊霞
刘晓方
甄建达
武彦霞
GUO Dandan;JIA Yinyu;ZHANG Zhaoxia;LIU Xiaofang;ZHEN Jianda;WU Yanxia(Emergency Department,the Second Affiliated Hospital of Xingtai Medical College,XingTai 054000,China;Emergency Department,Chengde Central Hospital,Chengde 067000,China;Outpatient Department,the Second Affiliated Hospital of Xingtai Medical College,XingTai 054000,China)
出处
《安徽医学》
2026年第3期308-313,共6页
Anhui Medical Journal
基金
邢台市市级科技计划自筹经费项目(编号:2016ZC076)。
