血浆组织蛋白酶S和血小板反应蛋白-1对急性大面积脑梗死患者住院病死率的预测价值分析  

Predictive value of plasma cathepsin S and thrombospondin-1 in the hospitalized mortality of patients with acute massive cerebral infarction

作　　者：刘慧[1] 王延辉[1] 郑敏[1] 姜浩威[1] LIU Hui;WANG Yanhui;ZHENG Min(Department of Neurology,No.242 Hospital,Liaoning,Shenyang 110034,China)

机构地区：[1]辽宁省沈阳二四二医院神经内科,110034

出　　处：《河北医药》2021年第8期1188-1191,1195,共5页Hebei Medical Journal

基　　金：辽宁省科学技术计划项目(编号:2017225173)。

摘　　要：目的检测急性大面积脑梗死(AMCI)患者血浆组织蛋白酶S(Cat S)和血小板反应蛋白-1(TSP-1)水平,探讨血浆Cat S、TSP-1水平对AMCI患者住院病死率的预测价值。方法选取2017年7月至2019年10月收治的AMCI患者112例作为观察组,根据30 d后的预后情况分为生存组(n=92)和死亡组(n=20),根据颈动脉狭窄程度分为轻度狭窄组(n=41)、中度狭窄组(n=43)和重度狭窄组(n=28),选取同期健康体检者115例为对照组。采集研究对象外周血,利用酶联免疫吸附法(ELISA)检测Cat S、TSP-1水平,使用全自动生化分析仪分析血脂指标总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平,采用Pearson法分析AMCI患者血浆Cat S、TSP-1与TG、TC、HDL-C、LDL-C水平的相关性,采用Logistic回归分析影响AMCI患者预后的因素,采用受试者工作特征(ROC)曲线评估血浆Cat S、TSP-1水平对AMCI的预后价值。结果与对照组比较,观察组患者血浆Cat S、TSP-1、TC、TG、LDL-C水平明显升高,HDL-C水平明显降低(P<0.05);随着颈动脉狭窄程度的加重,血浆Cat S、TSP-1、TC、TG、LDL-C水平明显升高,HDL-C水平明显降低(P<0.05);AMCI患者血浆Cat S、TSP-1水平与TC、TG水平,TSP-1水平与LDL-C水平均呈正相关(P<0.05),血浆Cat S、TSP-1水平与HDL-C水平均呈负相关(P<0.05);与生存组相比,死亡组AMCI患者血浆Cat S、TSP-1水平明显升高(P<0.05);血浆Cat S、TSP-1水平升高均为影响AMCI患者死亡的危险因素;Cat S预测AMCI患者死亡的ROC曲线下面积为0.734,截断值为73.61 pg/ml,敏感度、特异性分别为65.0%、78.3%;TSP-1的ROC曲线下面积为0.707,截断值为174.52 ng/ml,敏感度、特异性分别为85.0%、57.6%。结论AMCI患者血浆Cat S、TSP-1水平明显上调,其表达水平均随患者颈动脉狭窄程度的加重而异常表达严重,血浆Cat S、TSP-1水平均与血脂指标关系密切,Cat S、TSP-1可能通过调控血脂水平调节AMCI发生�Objective To detect the levels of the plasma cathepsin S(Cat S)and thrombospondin-1(TSP-1)in patients with acute massive cerebral infarction(AMCI),and to explore the predictive value of plasma Cat S and TSP-1 levels in the hospitalized mortality of patientts with AMCI.Methods A total of 112 patientts with AMCI who were treated in our hospital from July 2017 to October 2019 were enrolled as observation group.According to the prognosis at 30d after enrollment,who were divided into survival case group(n=92)and death case group(n=20).According to the severity of carotid artery stenosis(CAS),who were divided into mild stenosis group(n=41),moderate stenosis group(n=43)and severe stenosis group(n=28).At the same time the other 115 healthy subjects who underwent physical examination were enrolled as control group.The peripheral blood specimens wer collected,and the enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of Cat S and TSP-1.The automatic biochemical analyzer was used to analyze the blood lipid indicators,including total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)levels.Pearson method was used to analyze the correlation between plasma Cat S,TSP-1 and TG,TC,HDL-C,and LDL-C levels.Logistic regression analysis was used to analyze the factors affecting the prognosis of patients,and receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of plasma Cat S and TSP-1 levels for patients with AMCI.Results As compared with those in control group,the plasma levels of Cat S,TSP-1,TC,TG,and LDL-C in observation group were significantly increased,while HDL-C levels were significantly decreased(P<0.05).With the increase of severity of CAS,the levels of Cat S,TSP-1,TC,TG,and LDL-C were significantly increased,while HDL-C levels were significantly decreased(P<0.05).The levels of Cat S and TSP-1 were positively correlated with those of TC and TG,moreover,the TSP-1 levels were positively correlated with

关 键 词：血浆组织蛋白酶S 血小板反应蛋白-1 急性大面积脑梗死 住院病死率 

分 类 号：R743.33[医药卫生—神经病学与精神病学]