血清MCP-1、CyPA水平与急性脑梗死患者rt-PA静脉溶栓治疗预后的相关性  

Correlations Between Serum MCP-1,CyPA Levels and Prognosis of rt-PA Intravenous Thrombolysis in the Treatment of Patients with Acute Cerebral Infarction

作　　者：刘卫芳[1] 宋宏伟[1] 常秀红[1] LIU Weifang;SONG Hongwei;CHANG Xiuhong(Department of Emergency ICU,Puyang People’s Hospital,Puyang 457000,China)

机构地区：[1]濮阳市人民医院急诊ICU,河南濮阳457000

出　　处：《河南医学研究》2021年第28期5292-5295,共4页Henan Medical Research

摘　　要：目的分析血清单核细胞趋化蛋白1(MCP-1)、亲环素A(CyPA)水平与急性脑梗死患者(ACI)重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗预后的关系。方法前瞻性选取2019年1月至2020年7月濮阳市人民医院收治的符合溶栓治疗适应证的74例ACI患者,均接受rt-PA静脉溶栓治疗。测定入院时血清MCP-1、CyPA水平。出院后随访3个月,采用改良Rankin量表(mRS)评估患者预后情况,并将其分为预后良好组(46例)和预后不良组(28例),比较两组一般资料、实验室指标,并重点分析血清MCP-1、CyPA水平与ACI患者rt-PA静脉溶栓治疗预后的关系。结果74例患者均接受3个月随访,28例患者预后不良,占37.84%。预后不良组入院时血清MCP-1、CyPA水平高于预后良好组(P<0.05)。多因素logistic回归分析结果显示,入院时血清MCP-1、CyPA过表达与ACI患者rt-PA静脉溶栓治疗预后不良有关(P<0.05)。受试者工作特征(ROC)曲线结果显示,ACI患者入院时血清MCP-1、CyPA水平单独及联合预测rt-PA静脉溶栓治疗预后不良风险的AUC均>0.70,有一定预测价值,且以联合预测价值最佳,AUC>0.80。结论血清MCP-1、CyPA水平与ACI患者rt-PA静脉溶栓治疗预后有关。Objective To analyze the correlations between serum monocyte chemoattractant protein 1(MCP-1)and cyclophilin A(CyPA)levels and prognosis of recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis in the treatment of patients with acute cerebral infarction(ACI).Methods A total of 74 patients with ACI who met the indications for thrombolytic therapy in Puyang People’s Hospital from January 2019 to July 2020 were prospectively selected,and all the patients received rt-PA intravenous thrombolysis.The serum MCP-1 and CyPA levels were measured on admission.The patients were followed up for 3 months after discharge,and the modified Rankin scale(mRS)was used to evaluate the prognosis of patients,and they were divided into good prognosis group(46 cases)and poor prognosis group(28 cases).The general data and laboratory indicators of the two groups were compared,and the correlations between the serum MCP-1 and CyPA levels and prognosis of rt-PA intravenous thrombolysis in the treatment of patients with ACI were analyzed.Results The 74 patients were followed up for 3 months,and 28 patients had poor prognosis,accounting for 37.84%.The serum MCP-1 and CyPA levels in poor prognosis group were higher than those in good prognosis group(P<0.05).Multivariate logistic regression analysis showed that the overexpression of serum MCP-1 and CyPA on admission was related to the poor prognosis of rt-PA intravenous thrombolysis in the treatment of patients with ACI(P<0.05).The receiver operating characteristic(ROC)curve results showed that the areas under the curve(AUC)of serum MCP-1 and CyPA levels alone or in combination in the prediction of the poor prognosis of rt-PA intravenous thrombolysis in the treatment of patients with ACI were all>0.70,which had certain predictive value,and the combined predictive value was the best,with AUC>0.80.Conclusion The serum MCP-1 and CyPA levels are related to the prognosis of rt-PA intravenous thrombolysis in the treatment of patients with ACI.

关 键 词：急性脑梗死 静脉溶栓 重组组织型纤溶酶原激活剂 单核细胞趋化蛋白1 亲环素A 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]