急性缺血性脑卒中患者血清生长分化因子-15、钙调蛋白、氧化性低密度脂蛋白水平检测的临床意义  

Clinical significance of serum levels of growth differentiation factor-15,calmodulin and oxidative low density lipoprotein in patients with acute ischemic stroke

作　　者：蔡文灿[1] 刘彦明[1] 钱春艳[1] 陈伟娟 Cai Wencan;Liu Yanming;Qian Chunyan;Chen Weijuan(Department of Laboratory,the Shaoguan of Northern People's Hospital,Guangdong 512026,China)

机构地区：[1]韶关市粤北人民医院检验科,广东512026

出　　处：《脑与神经疾病杂志》2020年第4期208-212,共5页Journal of Brain and Nervous Diseases

基　　金：广东省自然科学基金项目(2016A030310377)。

摘　　要：目的探讨急性缺血性脑卒中(AIS)血清生长分化因子-15(GDF-15)、钙调蛋白(CAM)与氧化性低密度脂蛋白(ox-LDL)的水平变化及临床意义。方法选择2016年1月至2018年12月粤北人民医院收治的AIS患者148例作为研究组,根据患者入院时美国国立卫生研究院卒中量表(NIHSS)评分结果将患者分为轻中度组(NIHSS≤15分,n=82)和重度组(NIHSS>15,n=66);根据头颅MRI计算的脑梗死面积将其分为腔隙性梗死组(n=49)、中等面积脑梗死组(n=67)、大面积脑梗死组(n=32)根据患者出院3个月改良Rankin量表(MRS)结果将患者分为预后良好组(MRS≤2分,n=87)和预后不良组(3分≤MRS<5分,n=61),另选取同期医院体检健康人80例作为对照组,比较各组血清GDF-15、CAM与ox-LDL水平,采用受试者工作特征曲线评估其对患者预后的预测价值。结果研究组血清GDF-15、CAM与ox-LDL水平明显高于对照组(P<0.05)。重度组患者血清GDF-15、CAM与ox-LDL水平明显高于轻中度组患者。中等面积脑梗死组、大面积脑梗死组患者血清GDF-15、CAM、ox-LDL水平高于腔隙性梗死组,且大面积脑梗死组高于中等面积脑梗死组(P<0.05)。预后不良组患者血清GDF-15、CAM与ox-LDL水平明显高于预后良好组患者,数据有统计学意义(P<0.05)。血清GDF-15、CAM、ox-LDL对AIS预后均有一定的预测价值,联合检测预测AIS预后的AUC可达0.877(0.814,0.940),灵敏度、特异性分别为0.89、0.86,准确性为0.85。结论AIS患者血清GDF-15、CAM、ox-LDL水平异常升高,并与病情严重程度及预后密切相关,早期联合检测可作为评估病情及预测预后的重要指标。Objective To investigate the level changes and clinical significance of serum growth differentiation factor-15(GDF-15),calmodulin(CAM)and oxidized low density lipoprotein(ox-LDL)and the neurological function and prognosis of patients with acute ischemic stroke(AIS).Methods Selected 148 patients with AIS in Northern Guangdong People's Hospital from February 2017 to December 2018 as the study group.The patients were divided into mild and moderate group(NIHSS≤15,n=82)and severe group(NIHSS>15,n=66)according to the score of the stroke scale of the National Institutes of Health(NIHSS)at the admission of the hospital,which were divided into lacunar infarction group(n=49),moderate cerabral infarction(n=67)and large cerabral infarction(n=32)according to the area of cerabral infarction calculated by cranial MRI.The patients were discharged from hospital for 3 months.The results of the modified Rankin scale(MRS)were divided into good prognosis group(MRS<2,n=87)and poor prognosis group(3≤MRS<5 score,n=61),and 80 healthy people in the same period were selected as the control group.The serum GDF-15,CAM and ox-LDL levels were compared and the serum GDF-15 and CAM were analyzed in the patients with AIS.The receptor operating curve(ROC)was used to evaluate the predictive value for prognosis.Results The serum levels of GDF-15,CAM and ox-LDL in the study group were significantly higher than those in the control group(P<0.05).The serum levels of GDF-15,CAM and ox-LDL in the severe group were significantly higher than those in the mild and moderate group.The serum levels of GDF-15,CAM and ox-LDL in moderate cerabral infarction group and large cerabral infarction group were higher than those in lacunar infarction group,which in large cerabral infarction group were higher than those in moderate cerabral infarction(P<0.05).The serum levels of GDF-15,CAM and ox-LDL in the patients with poor prognosis were significantly higher than those in the good prognosis group,and the data were statistically significant(P<0.05).The serum GDF-15,

关 键 词：脑卒中 生长分化因子 钙调蛋白 氧化性低密度脂蛋白 神经功能 预后 

分 类 号：R743.32[医药卫生—神经病学与精神病学]