不同TOAST分型急性脑梗死患者血清CXC趋化因子配体16、碱性髓鞘蛋白、基质金属蛋白酶-9水平变化及临床意义  

Changes and clinical significance of serum CXCL16,MBP and MMP-9 levels in patients with different TOAST subtypes of cerebral infarction

作　　者：王婷 梁佳佳 WANG Ting;LIANG Jiajia(Department of Neurology,the First Hospital of Yulin,Yulin 719000,China)

机构地区：[1]榆林市第一医院神经内科,陕西榆林719000

出　　处：《陕西医学杂志》2021年第12期1581-1584,共4页Shaanxi Medical Journal

基　　金：陕西省重点研发计划项目(2018SF-169)。

摘　　要：目的:探讨根据类肝素药物治疗急性缺血性脑卒中试验(TOAST)分型后不同类型急性脑梗死(ACI)患者血清CXC趋化因子配体16(CXCL16)、碱性髓鞘蛋白(MBP)、基质金属蛋白酶-9(MMP-9)水平变化及临床意义。方法:随机选取137例ACI患者为观察组,选取同期健康体检者89例为对照组。比较两组血清CXCL16、MBP、MMP-9水平。根据TOAST对ACI患者进行分型,比较不同亚型ACI患者血清CXCL16、MBP、MMP-9水平。采用受试者工作特征(ROC)曲线分析CXCL16、MBP、MMP-9单项及联合对ACI的诊断效能。结果:观察组血清CXCL16、MBP、MMP-9水平均明显高于对照组(均P<0.05)。不同TOAST分型患者血清CXCL16、MBP、MMP-9水平比较,差异有统计学意义(均P<0.05);大动脉粥样硬化(LAA)组CXCL16、MMP-9水平明显高于其他亚型组,MBP水平明显高于小动脉闭塞型卒中(SAO)组、其他病因组及不明原因组(均P<0.05);心源性脑栓塞(CE)组CXCL16水平明显高于SAO组,MBP、MMP-9水平明显高于SAO组、其他病因组及不明原因组(均P<0.05);SAO组CXCL16、MBP水平明显低于其他病因组及不明原因组,MMP-9水平明显高于其他病因组(均P<0.05);其他病因组MBP水平明显高于不明原因组(P<0.05)。ROC曲线分析显示,血清CXCL16、MBP、MMP-9单项诊断早期ACI的曲线下面积(AUC)分别为0.814、0.838、0.808,三项联合诊断早期ACI的AUC为0.933,均具有较高的诊断效能。结论:ACI患者血清CXCL16、MBP、MMP-9水平均明显升高,且与TOAST分型密切相关,可作为临床早期诊断的检测指标。Objective:To investigate the changes and clinical significance of serum CXC chemokine ligand 16(CXCL16),myelin basic protein(MBP)and matrix metalloproteinase-9(MMP-9)in patients with different types of acute cerebral infarction(ACI)after typing according to trial of org 10172 in acute stroke treatment(TOAST).Methods:137 patients with ACI were randomly selected as the observation group and 89 healthy people in the same period were selected as the control group.The levels of serum CXCL16,MBP and MMP-9 were compared between the two groups.ACI patients were classified according to TOAST,and the levels of serum CXCL16,MBP and MMP-9 in patients with different subtypes of ACI were compared.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of CXCL16,MBP and MMP-9 in ACI.Results:The levels of serum CXCL16,MBP and MMP-9 in the observation group were significantly higher than those in the control group(all P<0.05).The levels of serum CXCL16,MBP and MMP-9 in patients with different TOAST typing were significantly different(all P<0.05);the levels of CXCL16 and MMP-9 in LAA group were significantly higher than those in other subtypes,and the level of MBP was significantly higher than that in SAO group,other etiology group and unexplained group(all P<0.05);the levels of CXCL16,MBP and MMP-9 in CE group were significantly higher than those in SAO group,other etiology group and unexplained group(all P<0.05);the levels of CXCL16 and MBP in SAO group were significantly lower than those in other etiology group and unexplained group,and the level of MMP-9 was significantly higher than that in other etiology group(all P<0.05);the level of MBP in other etiology group was significantly higher than that in unexplained group(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum CXCL16,MBP and MMP-9 in the single diagnosis of early ACI were 0.814,0.838 and 0.808 respectively,and the AUC of the three combined diagnosis of early ACI was 0.933,and they all had high diagnostic effici

关 键 词：急性脑梗死 CXC趋化因子配体16 碱性髓鞘蛋白 基质金属蛋白酶-9 类肝素药物治疗急性缺血性脑卒中试验 

分 类 号：R743.3[医药卫生—神经病学与精神病学]