血清CXCL16、CXCL12和CXCL4对老年急性脑梗死早期神经功能恶化的预测价值  

The value of serum CXCL16, CXCL12 and CXCL4 in predicting early deterioration of neurological function in elderly patients with acute cerebral infarction

作　　者：赵敏清 郭建文[3] 张泽舜[1] 秦德芳[1] 霍泳林 Zhao Minqing;Guo Jianwen;Zhang Zeshun;Qin Defang;Huo Yonglin(Department of Neurosurgery,Zhuhai Hospital,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou University of Traditional Chinese Medicine,Zhuhai,Guangdong,519000,P.R.China;Guangzhou University of Traditional Chinese Medicine,Guangzhou,Guangdong,510006,P.R.China;Department of Neurology,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou,Guangdong,510120,P.R.China)

机构地区：[1]广州中医药大学附属广东省中医院珠海医院神经外科,广东珠海519000 [2]广州中医药大学,广东广州510006 [3]广东省中医院神经内科,广东广州510120

出　　处：《老年医学与保健》2021年第6期1186-1190,共5页Geriatrics & Health Care

摘　　要：目的探究外周血清CXC趋化因子配体(CXCL16、CXCL12和CXCL4)对老年急性脑梗死(ACI)患者发生早期神经功能恶化(END)的预测价值,为诊治该病症提供参考。方法选择2020年1月—2020年12月广州中医药大学附属广东省中医院收治的123例急性脑梗死患者,根据其早期神经功能恶化发生情况分为未发生END组(n=92)与发生END组(n=31),评估并比较2组的临床资料、血清CXCL16、CXCL12和CXCL4水平,用spearman检验进行相关性分析,用Logistic回归模型分析急性脑梗死END的相关因素,用受试者工作特征曲线(ROC)分析血清CXCL16、CXCL12和CXCL4水平预测急性脑梗死END的价值。结果2组吸烟史、糖尿病史、白细胞计数、超敏C反应蛋白(hs-CRP)水平、美国国立卫生院神经功能缺损评分(NHISS)差异有统计学意义(P<0.05);与未发生END组比较,发生END组血清CXCL16、CXCL12和CXCL4水平显著升高(P<0.05)。相关性分析显示,CXCL16、CXCL12、CXCL4高水平与急性脑梗死发生END呈正相关(P<0.05)。Logistic回归模型分析显示,高NHISS评分和血清hs-CRP、CXCL16、CXCL12、CXCL4高水平是急性脑梗死发生END的危险因素(P<0.05)。ROC分析显示,血清CXCL16、CXCL12和CXCL4水平联合预测急性脑梗死END的价值较高,其AUC为0.852,灵敏度为74.23%,特异度为95.34%。结论血清CXCL16、CXCL12和CXCL4水平分别>17.35、10.64、13.83 ng/mL时有助于预测老年急性脑梗死END的发生,有较好的临床应用价值。Objective To explore the value of peripheral blood CXC chemokine ligand(CXCL16,CXCL12 and CXCL4)in predicting the early deterioration of neurological function in elderly patients with acute cerebral infarction,and to provide clinical reference for the treatment of this disease.Methods 123 patients with acute cerebral infarction treated in Guangdong Provincial Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine from January 2020 to December 2020 were selected.According to whether they had early neurological deterioration(END),they were divided into non-END group(n=92)and END group(n=31).The clinical data and levels of serum CXCL16,CXCL12 and CXCL4 were evaluated and compared between the two groups.Spearman test was used for correlation analysis,logistic regression model was used to analyze the related factors of END in patients with acute cerebral infarction,and receiver operating characteristic curve(ROC)was used to analyze the value of serum CXCL16,CXCL12 and CXCL4 in predicting END in patients with acute cerebral infarction.Results There were significant differences in smoking history,diabetes history,white blood cell count,hypersensitivity C-reactive protein(hs-CRP)level and National Institutes of Health Neurological Deficit(NHISS)score between the two groups(P<0.05).The levels of serum CXCL16,CXCL 12 and CXCL 4 of the END group were significantly higher than those of the non-END group(P<0.05).Correlation analysis showed that the high levels of CXCL16,CXCL12 and CXCL4 were positively correlated with END in elderly patients with acute cerebral infarction(P<0.05).Logistic regression analysis showed that high NHISS score and high levels of serum hs-CRP,CXCL16,CXCL12,and CXCL4 were risk factors for END in elderly patients with acute cerebral infarction(P<0.05).ROC analysis showed that the combination of serum CXCL16,CXCL12 and CXCL4 was of high value in predicting END in elderly patients with acute cerebral infarction.Its AUC was 0.852,sensitivity was 74.23%a

关 键 词：老年 急性脑梗死 早期神经功能恶化 CXCL16 CXCL12 CXCL4 预测价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]