血清趋化因子CXCL16和热休克蛋白70水平与急性脑梗死患者早期神经功能恶化的关系  

Relationship between serum chemokines CXCL16,HSP70 levels and early neurological deterioration in patients with acute cerebral infarction

作　　者：陈捷 程亚玲 陈海燕 官念 CHEN Jie;CHENG Yaling;CHEN Haiyan;GUAN Nian(Department of Neurology,West China Guang′an Hospital of Sichuan University,Guang′an 638000,China)

机构地区：[1]四川大学华西广安医院神经内科,四川广安638000 [2]四川大学华西广安医院心内科,四川广安638000

出　　处：《实用医学杂志》2019年第24期3803-3807,共5页The Journal of Practical Medicine

基　　金：四川省卫生和计划生育委员会科研课题(编号：17PJ090)

摘　　要：目的探究血清趋化因子CXCL16(chemokine CXCL16,CXCL16)和热休克蛋白70(heat shock protein 70,HSP70)水平与急性脑梗死(acute cerebral infarction,ACI)患者早期神经功能恶化(early neurological deterioration,END)的关系。方法回顾性分析2016年8月至2018年8月在四川大学华西广安医院接受治疗的165例ACI患者的临床资料。根据是否发生END将患者分为END组(52例)及非END组(113例),采用酶联免疫吸附法检测各组患者血清CXCL16及HSP70水平,比较2组患者各项临床资料。多因素Logistic回归分析ACI患者发生END的独立危险因素,ROC曲线分析CXCL16、HSP70预测END的准确性。结果END组房颤比例、入院时NIHSS评分≥12分占比及血清CXCL16含量高于非END组(t/χ^2=8.162、5.278、7.326;P=0.004、0.022,P<0.001),血清HSP70含量低于非END组(t=7.358,P<0.001)。ROC曲线分析结果显示,血清CXCL16水平预测END时ROC曲线下面积(area under the ROC curve,AUC)为0.804,截断值为0.221 ng/L;采用血清HSP70水平预测END时AUC为0.785,截断值为50.767 ng/mL。多因素Logistic回归分析结果显示血清CXCL16≥0.221 ng/L及HSP70<50.767 ng/mL均是ACI患者发生END的独立预测因子(P=0.022、0.038)。结论血清CXCL16、HSP70水平是ACI患者发生END独立预测因子,血清CXCL16及HSP70水平检测对ACI患者END的早期诊断及治疗具有十分重要的指导意义。Objective To explore relationship between serum chemokines CXCL16(CXCL16),heat shock protein 70(HSP70)levels and early neurological deterioration(END)in patients with acute cerebral infarction(ACI). Methods The clinical data of 165 ACI patients who were treated at Huaxi Guang′an Hospital of Sichuan University from August 2016 to August 2018 were retrospectively analyzed. According to presence or absence of END,they were divided into END group(52 cases)and non-END group(113 cases). The levels of serum CXCL16 and HSP70 in each group were measured by enzyme-linked immunosorbent assay(ELISA). All clinical data were compared between the two groups. Multivariate Logistic regression analysis was applied to analyze independent risk factors for occurrence of END in ACI patients. ROC curves were applied to analyze accuracy of CXCL16 and HSP70 for predicting END. Results The proportions of atrial fibrillation and NIHSS score not lower than 12 points at admission,and serum CXCL16 content in END group were higher than those in non-END group(t/χ2= 8.162,5.278,7.326;P = 0.004,0.022,P < 0.001),while serum HSP70 content was lower than that in non-END group(t = 7.358,P < 0.001). The results of ROC curve analysis showed that area under the ROC curve(AUC)and cut-off value of serum CXCL16 level for predicting END were 0.804 and 0.221 ng/L,respectively. The above two indexes of serum HSP70 level were 0.785 and 50.767 ng/mL,respectively. The results of multivariate Logistic regression analysis showed that serum CXCL16 not lower than 0.221 ng/L and HSP70 lower than 50.767 ng/mL were independent predictors for occurrence of END in ACI patients(P = 0.022,0.038). Conclusions The levels of serum CXCL16 and HSP70 are independent predictors for occurrence of END in ACI patients. The detection of serum CXCL16 and HSP70 levels is of great guidance significance for the early diagnosis and treatment of END in ACI patients.

关 键 词：趋化因子CXCL16 热休克蛋白70 急性脑梗死 早期神经功能恶化 预测 影响因素 

分 类 号：R74[医药卫生—神经病学与精神病学]