血清PGC-1α、Irisin水平对急性缺血性脑卒中患者出血转化的预测价值  

Predictive value of levels of serum PGC-1αand Irisin for hemorrhagic transformation in patients with acute ischemic stroke

作　　者：平会坤 刘丽[1] 于彩敏[1] 余兰 PING Huikun;LIU Li;YU Caimin;YU Lan(Department of Neurology,Dingzhou People′s Hospital,Dingzhou,Hebei 073000,China;Department of Neurology,Second Hospital of Baoding City,Baoding,Hebei 071051,China)

机构地区：[1]定州市人民医院神经内科,河北定州073000 [2]保定市第二医院神经内科,河北保定071051

出　　处：《国际检验医学杂志》2021年第13期1575-1579,共5页International Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题计划项目(20191809)。

摘　　要：目的探讨血清过氧化物酶体增殖物激活受体γ辅助激活因子-1α(PGC-1α)、鸢尾素(Irisin)水平对急性缺血性脑卒中(AIS)患者出血转化(HT)的预测价值。方法选取2018年8月至2020年6月定州市人民医院收治的AIS患者124例为研究对象,根据患者头颅CT复查结果将其分为HT组(53例)和非HT组(71例)。比较两组基线资料及血清学指标,采用酶联免疫吸附试验(ELISA)检测血清PGC-1α、Irisin水平,采用Pearson法分析HT组患者血清PGC-1α、Irisin水平的相关性,采用受试者工作特征(ROC)曲线评价血清PGC-1α、Irisin水平对AIS患者发生HT的预测价值,采用多因素Logistic回归分析影响AIS患者发生HT的危险因素。结果HT组患者发病至溶栓时间、入院时美国国立卫生研究院卒中量表(NIHSS)评分、血小板计数均明显高于非HT组,血清PGC-1α、Irisin水平均明显低于非HT组,差异均有统计学意义(P<0.05);Pearson相关分析结果显示,HT组患者血清PGC-1α水平与Irisin水平呈正相关(r=0.562,P<0.05);ROC曲线分析结果显示,血清PGC-1α、Irisin预测AIS患者发生HT的曲线下面积(AUC)分别为0.886(95%CI:0.817~0.936)、0.811(95%CI:0.731~0.876),对应的敏感度分别为83.02%、67.92%,特异度分别为80.28%、81.69%;二者联合预测的AUC为0.934(95%CI:0.874~0.970),敏感度和特异度分别为86.79%、85.92%;多因素Logistic分析结果显示,发病至静脉溶栓时间≥4 h、入院时NIHSS评分>13分、PGC-1α≤0.58 ng/mL、Irisin≤79.40μg/L是影响AIS患者发生HT的危险因素(P<0.05)。结论血清PGC-1α、Irisin水平在AIS合并HT患者中低表达,是患者发生HT的危险因素,提示PGC-1α、Irisin可能作为预测AIS患者发生HT的血清标志物。Objective To investigate the predictive value of levels of serum peroxisome proliferator-activated receptor gamma coactivator 1α(PGC-1α)and Irisin in predicting hemorrhagic transformation(HT)in patients with acute ischemic stroke(AIS).Methods A total of 124 AIS patients admitted to Dingzhou People′s Hospital from August 2018 to June 2020 were selected and divided into HT group(53 cases)and non HT group(71 cases)according to the results of head CT reexamination.The baseline data and serological indexes were compared between the two groups.The levels of serum PGC-1αand Irisin were detected by enzyme-linked immunosorbent assay(ELISA).Pearson method was used to analyze the correlation between levels of serum PGC-1αand Irisin in HT group,receiver operating characteristic(ROC)curve was used to evaluate the predictive value of levels of serum PGC-1αand Irisin for HT in AIS patients,while multivariate Logistic regression was used to analyze the risk factors of HT in AIS patients.Results The time from onset to thrombolysis,National Institute of Health stroke scale(NIHSS)score at admission,platelet count of AIS patients in HT group were significantly higher than those in non HT group(P<0.05),and levels of serum PGC-1αand Irisin were significantly lower than those in non HT group(P<0.05).Pearson correction analysis results showed that levels of serum PGC-1αand Irisin were positively correlated in HT group(r=0.562,P<0.05).ROC analysis results showed that the area under the curve(AUC)of serum PGC-1αand Irisin in predicting HT in AIS patients were 0.886(95%CI:0.817-0.936)and 0.811(95%CI:0.731-0.876),the corresponding sensitivity were 83.02%and 67.92%,and the specificity were 80.28%and 81.69%,respectively.In addition,the AUC of the combined diagnosis was 0.934(95%CI:0.874-0.970),and the sensitivity and specificity were 86.79%and 85.92%,respectively.Multivariate Logistic analysis showed that time from onset to intravenous thrombolysis≥4 h,NIHSS score>13,PGC-1α≤0.58 ng/mL,Irisin≤79.40 g/L were risk factors for HT

关 键 词：过氧化物酶体增殖物激活受体γ辅助激活因子-1α 鸢尾素 急性缺血性脑卒中 出血转化 预测价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]