急性缺血性脑卒中患者血清CCCK-18、CTRP3水平变化及临床意义  

CCCK-18 and CTRP3 changes in serum of patients with acute ischemic stroke and their clinical significance

作　　者：李霞[1] 陈艳洁[1] 刘泽民[1] 李艳琴[1] 段玉香[1] 张凤莲[1] LI Xia;CHEN Yanjie;LIU Zemin(Department of Neurology,Tangshan People’s Hospital,Tangshan 063000,China)

机构地区：[1]河北省唐山市人民医院神经内科,河北唐山063000

出　　处：《中风与神经疾病杂志》2021年第8期685-688,共4页Journal of Apoplexy and Nervous Diseases

基　　金：河北省医学科研课题(No.201801158)。

摘　　要：目的探讨急性缺血性脑卒中(AIS)患者血清半胱氨酸蛋白酶裂解细胞角蛋白-18(CCCK-18)、补体1q肿瘤坏死因子相关蛋白3(CTRP3)水平变化及临床意义。方法选取163例AIS患者为AIS组,根据美国国立卫生研究院卒中量表(NIHSS)将患者分为轻度缺损组(49例)、中度缺损组(76例)、重度缺损组(38例),治疗3个月后根据改良Rankin量表(mRS)将患者分为预后不良组(66例)和预后良好组(97例),另选取同期72例体检健康者为对照组。采用酶联免疫吸附法测定血清CCCK-18、CTRP3水平。结果AIS组血清CCCK-18水平明显高于对照组,CTRP3水平明显低于对照组(P<0.05)。轻、中、重缺损度组血清CCCK-18水平逐渐提升,CTRP3水平逐渐降低(P<0.05)。血清CCCK-18水平与NIHSS评分呈正相关;CTRP3水平与NIHSS评分呈负相关(P<0.05)。多因素Logistics回归分析显示,大面积梗死、高NIHSS评分、高CCCK-18水平为AIS患者预后不良独立危险因素,高CTRP3水平为独立保护因素(P<0.05)。ROC曲线显示,CCCK-18联合CTRP3预测AIS患者预后不良的AUC明显大于CCCK-18、CTRP3单独预测(P<0.05),敏感度、特异度为86.36%、81.44%。结论AIS患者血清CCCK-18水平上调,CTRP3水平下调,与病情严重程度和预后不良有关,联合检测二者能提升预后不良预测价值。Objective To investigate the changes and clinical significance of serum caspase-cleaved cytokeratin-18(CCCK-18)and complement 1q tumor necrosis factor-related protein 3(CTRP3)levels in patients with acute ischemic stroke(AIS).Methods A total of 163 AIS patients were selected as the AIS group.According to the National Institutes of Health Stroke Scale(NIHSS),the patients were divided into the mild defect group(49 cases),moderate defect group(76 cases),severe defect group(38 cases),after 3 months of treatment,patients were divided into poor prognosis group(66 cases)and good prognosis group(97 cases)according to the modified Rankin scale(mRS),in addition,72 healthy individuals who had physical examination during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to determine serum CCCK-18 and CTRP3 levels.Results The serum CCCK-18 level in the AIS group was significantly higher than that in the control group,and the CTRP3 level was significantly lower than that in the control group(P<0.05).The serum CCCK-18 level in the mild,moderate,and severe defect groups gradually increased,and the CTRP3 level gradually decreased(P<0.05).The serum CCCK-18 level was positively correlated with NIHSS score,and CTRP3 level was negatively correlated with NIHSS score(P<0.05).Multivariate logistic regression analysis showed that large area infarction,high NIHSS score,high CCCK-18 level were an independent risk factor for poor prognosis in AIS patients,and high CTRP3 level was an independent protective factor(P<0.05).The ROC curve showed that the AUC of CCCK-18 combined CTRP3 predicting poor prognosis of AIS patients was significantly greater than that of CCCK-18,CTRP3 alone predicted(P<0.05),the sensitivity and specificity were 86.36%and 81.44%.Conclusion The serum CCCK-18 level in AIS patients is up-regulated,and the CTRP3 level is down-regulated,which is related to the severity of the disease and poor prognosis.Combined detection of the two can improve the predictive value of poor prognosis.

关 键 词：急性缺血性脑卒中 半胱氨酸蛋白酶裂解细胞角蛋白-18 补体1q肿瘤坏死因子相关蛋白3 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]