急性缺血性脑卒中患者血清血小板膜糖蛋白水平的变化及对预后的评估价值  

Changes of Serum Platelet Membrane Glycoprotein in Patients with Acute Ischemic Stroke and Its Prognostic Value

作　　者：马衣日木·赛买提[1] 穆妮热·赛买提 王倩[1] 哈斯也提·依不来音[1] MAYIRIMU·Saimaiti;MUNIRE·Saimaiti;WANG Qian;HASYETI·Yibulaiyin(Department of Neurology, The Second Affiliated Hospital of Xinjiang Medical University,Wurumqi 830063, China)

机构地区：[1]新疆医科大学第二附属医院神经内科,新疆乌鲁木齐830063

出　　处：《标记免疫分析与临床》2021年第6期917-921,共5页Labeled Immunoassays and Clinical Medicine

基　　金：新疆维吾尔自治区卫健委科研项目(编号:WJWY-202138)。

摘　　要：目的分析急性缺血性脑卒中患者入院时血清血小板膜糖蛋白-血小板活化因子-1(PAF-1)水平与疾病严重程度和患者90d临床预后的关系,为疾病早期诊断和预后评估提供敏感的生化指标。方法选择2019年3月至2020年9月入我院初次确诊急性缺血性脑卒中患者共102例,采用改良Rankin量表(MRS)评分评估观察组出院后90d神经预后,并以此分为良好组(共81例,MRS评分0~2分)和较差组(共21例,MRS评分3~6分)。另选同期门诊体检的80名健康人员作为对照组。分析患者入院血清PAF-1水平与美国国立卫生研究院卒中量表(NIHSS)评分的相关性;比较两组临床资料以及相关生化指标和入院PAF-1水平的差异。采用多因素Logistic回归分析筛选观察组90d预后的主要影响因素,采用受试者工作曲线(ROC)分析入院PAF-1水平预测90 d预后的效能。结果缺血性脑卒中组血清PAF-1水平高于对照组(P<0.01)。患者入院血清PAF-1水平与NIHSS评分呈现较好的正相关性(r=0.812,P=0.008)。治疗90d预后良好组的PAF-1水平、NIHSS评分和梗死体积明显小于较差组(P<0.05)。多因素Logistic回归分析显示,入院PAF-1水平和NIHSS评分是90d预后的主要影响因素(P<0.05)。ROC分析显示,入院PAF-1水平截断值为9.5ng/mL预测90d预后不良的AUC为0.867,灵敏度为80.5%,特异性为73.6%。结论急性缺血性脑卒中患者血清PAF-1水平升高与疾病发生以及90 d预后有紧密联系,可作为临床早期诊断脑卒中和判断短期预后的重要生化指标。Objective To analyze the relationship between serum platelet membrane glycoprotein,that is platelet activating factor-1(PAF-1)level in patients with acute ischemic stroke and the severity of disease,90-day prognosis,so as to provide a sensitive biochemical indicator for the early diagnosis and prognosis evaluation.Methods A total of 102 patients with acute ischemic stroke(AIS)admitted into our hospital from March,2019 to September,2019 were chosen and evaluated for the prognosis of 90 days post-therapy by modified Rankin Scale(MRS)score.All patients were divided into two group according to MRS,which were the prognosis better group(81 cases,0-2)and prognosis poor group(21 cases,3-6).Another 80 healthy people in the same period were selected as the control group.The correlation between serum PAF-1 level and NIHSS score in patients with AIS was analyzed.The clinical data,biochemical indexes and serum PAF-1 level were compared between the two groups.The risk factors of 90-day prognosis in patients with AIS to the clinical indexes were confirmed by multivariate logistic analysis.The diagnostic value of the serum levels of PAF-1 to the 90-day prognosis in patients with AIS were analyzed by receiver operating characteristic curves(ROC).Results The level of serum PAF-1 in the ischemic stroke group was higher than that of the control group(P<0.01).Pearson analysis showed that serum PAF-1 level in patients with AIS was positively correlated with NIHSS score(r=0.812,P=0.008).The serum levels of PAF-1,NIHSS scores and infarct volume in the prognosis better group were lower than that of the prognosis poor group(P<0.05).Multivariate logistic analysis showed that the serum levels of PAF-1 and NIHSS scores were independent risk factors to 90-day prognosis in patients with AIS(P<0.05).When the cut-off point of serum PAF-1 level was 9.5 ng/mL,the sensitivity was 80.5%and specificity was 73.6%.Conclusion Higher serum PAF-1 expression in patients with acute ischemic stroke is closely related to the occurrence and 90-day prognosis of

关 键 词：急性缺血性脑卒中 血小板活化因子-1 美国国立卫生研究院卒中量表 改良Rankin量表 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]