血清细胞角质蛋白片段18在缺血性脑卒中患者的变化及诊断价值  

Expression of serum caspase-cleaved cytokeratin 18 in patients with cerebral ischemic stroke and its diagnostic value

作　　者：杨光 惠越[2] Yang Guang;Hui Yue(Department of Emergency,Affiliated Dongfeng Hospital,Hubei University of Medicine,Hubei Shiyan 442008,China;Department of Critical Care Medicine,Taihe Hospital,Hubei Shiyan 442000,China)

机构地区：[1]湖北医药学院附属东风医院急诊科,湖北十堰442008 [2]湖北省十堰市太和医院重症医学科,442000

出　　处：《中国医师进修杂志》2021年第2期118-122,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨血清细胞角质蛋白片段18(CCCK-18)在缺血性脑卒中(CIS)患者的变化及诊断价值。方法选取2018年10月至2019年10月湖北医药学院附属东风医院诊治的106例CIS患者作为研究组,同期行数字减影全脑血管造影(DSA)检查显示颅内外无显著异常的其他颅脑疾病患者90例作为对照组,两组基线资料比较差异无统计学意义(P>0.05)。采集两组研究对象肘静脉血5 ml,采用酶联免疫吸附法检测血清CCCK-18水平;酶法检测总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)。利用受试者工作特征(ROC)曲线分析血清CCCK-18对CIS患者的诊断效能,Pearson检验分析血清CCCK-18水平与TC、TG、LDL-C、HDL-C的相关性。结果研究组血清CCCK-18、TC、TG、LDL-C水平明显高于对照组[(158.10±50.89)U/L比(85.57±35.25)U/L、(4.26±0.92)mmol/L比(3.92±0.80)mmol/L、(2.34±0.53)mmol/L比(1.83±0.47)mmol/L、(3.12±0.73)mmol/L比(2.61±0.67)mmol/L],HDL-C低于对照组[(1.20±0.24)mmol/L比(1.32±0.28)mmol/L],差异有统计学意义(P<0.05)。Logistic回归分析结果显示,CCCK-18、TC、TG、LDL-C、HDL-C是CIS患者独立危险因素(P<0.05)。血清CCCK-18鉴别CIS患者与对照组的曲线下面积(AUC)为0.878,灵敏度和特异度分别为84.91%、78.89%;鉴别轻度CIS患者AUC为0.763,灵敏度和特异度分别为70.37%、78.89%。相关性分析显示,CIS患者血清CCCK-18与TC、TG、LDL-C呈正相关(r=0.711、0.722、0.705),与HDL-C呈负相关(r=-0.714),差异均有统计学意义(P<0.01)。结论CIS患者血清CCCK-18水平明显增高,可作为患者诊断和评估病情严重程度的生物学标志物。Objective To investigate the expression of serum caspase-cleaved cytokeratin 18(CCCK-18)in patients with cerebral ischemic stroke and its diagnostic value.Methods One hundred and six patients with cerebral ischemic stroke who were diagnosed and treated in Affiliated Dongfeng Hospital from October 2018 to October 2019 were selected as the study group.Ninety patients who underwent digital subtraction angiography(DSA)during the same period and showed no other abnormalities inside or outside the skull were selected as control group.The baseline data of gender,age,drinking history,smoking history,hypertension history,diabetes history,coronary heart disease,and other subjects in the two groups had no significant differences(P>0.05).Cubital venous blood of 5 ml from two groups of subjects were collected,and the level of serum CCCK-18 was detected by enzyme-linked immunosorbent assay.The levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)were detected by enzymatic method.The receiver operating characteristic curve(ROC curve)was used to analyze the diagnostic efficacy of serum CCCK-18 in patients with ischemic stroke,and the relationship between serum CCCK-18 and TC,TG,LDL-C,HDL-C were analyzed by Pearson test.Results The levels of serum CCCK-18,TC,TG,and LDL-C in the study group were significantly higher than those in the control group:(158.10±50.89)U/L vs.(85.57±35.25)U/L,(4.26±0.92)mmol/L vs.(3.92±0.80)mmol/L,(2.34±0.53)mmol/L vs.(1.83±0.47)mmol/L,(3.12±0.73)mmol/L vs.(2.61±0.67)mmol/L,and HDL-C level was lower than that in the control group:(1.20±0.24)mmol/L vs.(1.32±0.28)mmol/L,and there were significant differences(P<0.05).Logistic regression analysis showed that CCCK-18,TC,TG,LDL-C,and HDL-C were independent risk factors for patients with ischemic stroke(P<0.05).The area under the curve(AUC)of serum CCCK-18 to distinguish ischemic stroke from the control group was 0.878,with a sensitivity of 84.91%and a specificity of 78.8

关 键 词：脑梗塞 细胞角质蛋白18裂解片段 诊断 鉴别 回归分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]