急性缺血性脑卒中患者血清NfL、Galectin-3、Netrin-1水平变化及临床意义  

Changes of Serum NfL,Galectin-3 and Netrin-1 Levels in Patients withAcute Ischemic Stroke and Their Clinical Significances

作　　者：吉康[1] 文娟[1] 钟亮晶 曾德华 JI Kang;WEN Juan;ZHONG Liangjing;ZENG Dehua(Dongfang People’s Hospital,Dongfang 572600,China;Central South University XiangyaSchool of Medicine Affiliated Haikou Hospital,Haikou 570208,China)

机构地区：[1]东方市人民医院内一科,海南东方572600 [2]中南大学湘雅医学院附属海口医院神经内科,海南海口570208

出　　处：《标记免疫分析与临床》2021年第9期1579-1583,共5页Labeled Immunoassays and Clinical Medicine

基　　金：海南自然科学基金面上项目(编号:817373)。

摘　　要：目的探讨急性缺血性脑卒中患者血清神经丝轻链(NfL)、半乳糖凝集素-3(Galectin-3)、神经导向因子(Netrin-1)水平变化及临床意义。方法选取2017年6月至2020年6月我科收治的130例急性缺血性脑卒中患者作为观察组,根据神经功能缺损程度,将其分为轻度组(n=33)、中度组(n=56)和重度组(n=41)。同期,另选取我院体检健康人群100例(对照组)。应用酶联免疫吸附法检测血清NfL、Galectin-3、Netrin-1水平。出院后随访90 d,采用改良Rankin量表(mRS)评分评估患者神经功能预后,采用多因素Logistic回归分析影响急性缺血性脑卒中患者临床预后的危险因素。绘制ROC曲线,分析血清NfL、Galectin-3、Netrin-1对患者不良预后的评估价值。结果观察组血清NfL、Galectin-3、Netrin-1水平与对照组血清NfL、Galectin-3、Netrin-1水平相比,差异有统计学意义(P<0.05)。不同神经功能缺损程度的血清NfL、Galectin-3、Netrin-1水平相比,差异有统计学意义(P<0.05)。预后不良组血清NfL、Galectin-3水平高于预后良好组,血清Netrin-1水平低于预后良好组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果示,血清NfL、Galectin-3、Netrin-1是影响急性缺血性脑卒中患者短期预后的独立危险因素(P<0.05)。ROC曲线结果示,血清NfL、Galectin-3、Netrin-1及三者联合检测预测急性缺血性脑卒中患者不良预后的AUC分别为0.769、0.784、0.811、0.892。结论急性缺血性脑卒中患者血清NfL、Galectin-3水平升高,血清Netrin-1水平降低,其血清水平变化与患者神经功能缺损程度和短期不良预后有关,可作为急性缺血性脑卒中患者神经功能预后评估的参考指标。Objective To investigate changes and clinical significances of serum neurofilament light chain(NfL),galectin-3(Galectin-3)and neural guidance factor(Netrin-1)levels in patients with acute ischemic stroke.Methods 130 patients with acute ischemic stroke admitted to our department from June,2017 to June,2020 were selected as the observation group.According to the degree of neurological impairment,these patients were divided into the mild group(n=33),moderate group(n=56)and severe group(n=41).During the same period,another 100 healthy people(control group)were selected from physical examination in our hospital.Enzyme-linked immunosorbent assay was conducted to detect serum levels of NfL,Galectin-3 and Netrin-1.These patients were followed up for 90 days after discharge.The modified Rankin Scale(mRS)score was applied to evaluate the prognosis of the patient’s neurological function.Multivariate logistic regression was performed to analyze the risk factors affecting the clinical prognosis of patients with acute ischemic stroke.ROC curve was drawn to evaluate values of serum NfL,Galectin-3,Netrin-1 for the poor prognosis of patients.Results Serum levels of NfL,Galectin-3,and Netrin-1 in the observation group were significantly different from those in the control group(P<0.05).There were statistically significant differences in serum NfL,Galectin-3,and Netrin-1 levels of different neurological deficits(P<0.05).Levels of serum NfL and Galectin-3 in the poor prognosis group were higher than those in the good prognosis group,while serum Netrin-1 level was lower than that in the good prognosis group(P<0.05).Multivariate logistic regression analysis showed that serum NfL,Galectin-3 and Netrin-1 were independent risk factors affecting the short-term prognosis of patients with acute ischemic stroke(P<0.05).ROC curve results showed that AUC of serum NfL,Galectin-3,Netrin-1 and the combined detection of the three to predict the poor prognosis of patients with acute ischemic stroke were 0.769,0.784,0.811,and 0.892,respectively.Co

关 键 词：急性缺血性脑卒中 神经丝轻链 半乳糖凝集素-3 神经导向因子 

分 类 号：R743.31[医药卫生—神经病学与精神病学]