水通道蛋白-4及相关临床指标与大面积脑梗死并发脑水肿的关系  

The relationship between aquaporin 4 and related clinical indicators and large-area cerebral infarction with cerebral edema.

作　　者：洪波 常焕显[1] 季晓宇[1] 刘丽艳[1] 孔令胜[1] 赵平 Hong Bo;Chang Huanxian;Ji Xiaoyu;Liu Liyan;Kong Lingsheng;Zhao Ping(Department of Neurology, Lianyungang Municipal Oriental Hospital, Jiangsu Province,Lianyungang 222046,China)

机构地区：[1]江苏省连云港市东方医院神经内科,222046

出　　处：《疑难病杂志》2021年第5期465-469,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：连云港市科技计划(社会发展)项目(SH1604)。

摘　　要：目的研究水通道蛋白-4(AQP-4)及相关临床指标与大面积脑梗死发生脑水肿的关系。方法选取2016年11月—2018年4月连云港市市立东方医院神经内科收治的60例大面积脑梗死患者纳入研究均给予重组组织型纤溶酶原激活物治疗,依据患者治疗后24 h是否发生脑水肿分为脑水肿组(n=27)和无脑水肿组(n=33)。对比2组性别、年龄、身体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、神经功能缺损评分(NIHSS)、梗死部位、高血压病史、心脏病病史、脑卒中病史、吸烟史、饮酒史及血清丙氨酸氨基转氨酶(ALT)、天冬氨酸氨基转移酶(AST)、血尿酸(BUA)、空腹血糖(FPG)、肌酐(SCr)、AQP-4水平;通过ROC分析NIHSS、FPG、AQP-4预测大面积脑梗死发生脑水肿的价值,最后通过多因素Logistic回归分析明确大面积脑梗死患者出现脑水肿的危险因素。结果脑水肿组NIHSS评分及血清FPG、AQP-4水平显著高于无脑水肿组,差异有统计学意义(t=6.021、2.857、8.231,P<0.01)。经ROC分析证实,NIHSS评分及血清FPG、AQP-4水平均能用于大面积脑梗死发生脑水肿的预测,曲线下面积分别为0.789、0.943、0.849(P<0.05)。经多因素Logistic回归分析证实NIHSS≥13.915分,FPG≥8.51 mmol/L,AQP-4≥0.64 pg/ml是大面积脑梗死患者出现脑水肿的危险因素(P<0.05)。结论NIHSS评分及FPG、AQP-4是大面积脑梗死患者出现脑水肿的危险因素,可用于患者发生脑水肿的预测。Objective To study the relationship between aquaporin 4(AQP4)and related clinical indicators and cerebral edema in large areas of cerebral infarction.Methods Sixty patients with large-area cerebral infarction were selected into the study and all were treated with recombinant tissue-type plasminogen activator.According to whether the patients had cerebral edema 24 hours after treatment,they were divided into cerebral edema group(n=27)and no cerebral edema group(n=33).Compare the two groups of gender,age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),neurological deficit score(NIHSS),infarct location,history of hypertension,history of heart disease,history of stroke,smoking History,drinking history,and serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood uric acid(BUA),fasting blood glucose(FPG),creatinine(SCr),and AQP4 levels;analyze NIHSS by ROC,FPG,AQP4 predict the value of cerebral edema in patients with large-area cerebral infarction,and finally through multivariate logistic regression analysis to clarify the risk factors of cerebral edema in patients with large-area cerebral infarction.Results The NIHSS score and serum FPG and AQP4 levels in the brain edema group were significantly higher than those in the no brain edema group,and the difference was statistically significant(t=6.021,2.857,8.231,P<0.01).ROC analysis confirmed that the NIHSS score and serum FPG and AQP4 levels can be used to predict cerebral edema in large-scale cerebral infarction,and the areas under the curve are 0.789,0.943,and 0.849,respectively(P<0.05).Multivariate logistic regression analysis confirmed that NIHSS≥13.915 points,FPG≥8.51 mmol/L,and AQP4≥0.64 pg/ml were risk factors for cerebral edema in patients with large-area cerebral infarction(P<0.05).Conclusion NIHSS,FPG,and AQP4 are risk factors for cerebral edema in patients with large-area cerebral infarction,and can be used to predict the occurrence of cerebral edema in patients.

关 键 词：大面积脑梗死 脑水肿 水通道蛋白-4 

分 类 号：R542.2[医药卫生—心血管疾病]