β_(2)-微球蛋白与缺血性脑卒中关系的临床研究  

Clinical Study on Relationship Between β_(2)-Microglobulin and Cerebral Ischemic Stroke

作　　者：张嘉祯 姚文山[2] 鲁璐清 李思恒 闵连秋 Zhang Jiazhen;Yao Wenshan;Lu Luqing;Li Siheng;Min Lianqiu(The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China;Medical and Nursing Branch,Panjin Vocational and Technical College,Panjin 124000 China;Kailuan Mine Administrative Bureau Hospital,Tangshan 063005 China)

机构地区：[1]锦州医科大学附属第一医院,辽宁锦州121000 [2]盘锦职业技术学院医疗护理分院,辽宁盘锦124000 [3]唐山市开滦矿务局医院,河北唐山063005

出　　处：《锦州医科大学学报》2021年第3期40-43,共4页Journal of Jinzhou Medical University

基　　金：辽宁省自然科学基金指导计划项目,项目编号:20170540379。

摘　　要：目的探讨β2-微球蛋白(β2-microglobulin,β2-MG)与缺血性脑卒中(cerebral ischemic stroke,CIS)的关系及其临床应用价值。方法收集2014年3月至2015年1月在锦州医科大学附属第一医院神经内科住院治疗的急性缺血性脑卒中患者为研究组,诊断符合《中国急性缺血性脑卒中诊治指南2018》中的诊断标准,根据入院时美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分将研究组进一步分为轻型:≤3分,中型:4~14分,重型≥15分,并选取同期在锦州医科大学附属第一医院体检中心做健康检查的健康体检者作为对照组。采用标准调查表主要收集研究对象的β2-MG、同型半胱氨酸(homocysteine,HCY)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白(high-density lipoprotein,HDL)、低密度脂蛋白(low-density lipoprotein,LDL)、血肌酐(serum creatinine,Scr)和尿素氮(blood urea nitrogen,BUN)指标,并进行相关分析。所有数据均采用SPSS 23.0软件进行统计学分析。结果(1)与对照组相比,研究组的TC、HDL、BUN和Scr水平无显著性差异(P>0.05);而β2-MG、HCY、LDL和TG水平明显升高,具有显著性差异(P<0.05);(2)经SNK检验未见轻、中和重型病情缺血性脑卒中患者之间β2-MG水平的显著差异(P>0.05);(3)β2-MG与HCY和TG均不相关(P>0.05),与LDL呈正相关(r=0.66,P<0.05);(4)通过应用ROC曲线,发现β2-MG的AUC为0.820,诊断的准确性高于HCY(AUC为0.655)和LDL(AUC为0.650);而TG的AUC无统计学意义(P>0.05)。β2-MG的灵敏度为0.810,特异度为0.750,HCY的灵敏度为0.700,特异度为0.700,LDL灵敏度为0.380,特异度为0.800。结论β2-MG是缺血性脑卒中的主要危险因素,可作为预测缺血性脑卒中的参考指标。Objective To investigate the relationship betweenβ_(2)-microglobulin(β_(2)-MG)and cerebral ischemic stroke(CIS)and its clinical value.Methods The patients with acute ischemic stroke hospitalized in the Department of Neurology of the First Affiliated Hospital of Jinzhou Medical University from March 2014 to January 2015 were collected as the study group.Their diagnosis met the diagnostic criteria in the Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke of 2018.According to their scores of the National Institute of Health Stroke Scale(NIHSS)when they were admitted,the study group was further divided into 3 groups,mild group with points≤3,moderate group with points from 4 to 14,and severe group with points≥15.Healthy people who underwent health examination in the physical examination center of the First Affiliated Hospital of Jinzhou Medical University during the same period were selected as the control group.Standard questionnaire was used to collectβ_(2)-MG,homocysteine(HCY),triglyceride(TG),total cholesterol(TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL),serum creatinine(Scr)and blood urea nitrogen(BUN)of the subjects,and the correlation analysis was conducted.All data were statistically analyzed using SPSS 23.0 software.Results(1)Compared with the control group,the levels of TC,HDL,BUN and Scr in the study group were not significantly different(P>0.05),while the levels ofβ_(2)-MG,HCY,LDL and TG were significantly increased,with noticeable difference(P<0.05);(2)SNK test showed no significant difference in the level ofβ_(2)-MG among the patients with mild,moderate and severe ischemic stroke(P>0.05);(3)β_(2)-Mg was not correlated with HCY or TG(P>0.05),but was positively correlated with LDL(r=0.66,P<0.05);(4)The results of ROC curve showed that the diagnostic accuracy ofβ_(2)-MG whose AUC was 0.820 was higher than that of HCY(0.655)and LDL(0.650).The AUC of TG was not statistically significant(P>0.05).The sensitivity and specificity ofβ_(2)-MG were 0.810 and 0.7

关 键 词：β_(2)-微球蛋白 缺血性脑卒中 危险因素 

分 类 号：R965.2[医药卫生—药理学]