急性脑梗死静脉溶栓患者血清Galectin-1,Galectin-3的水平变化及其临床意义  

Changes and significance of galectin-1 andgalectin-3 in serum of patients with acute cerebral infarct after intravenous thrombolysis

作　　者：王丽香 李强 贾晓菲 周雪梅 于振江 Wang Lixiang;Li Qiang;Jia Xiaofei(Department of Neurology,Jinan 8th People’s Hospital,Jinan Shandong271100)

机构地区：[1]济南市第八人民医院神经内科,271100 [2]济南市钢城区人民医院

出　　处：《卒中与神经疾病》2022年第1期13-18,共6页Stroke and Nervous Diseases

基　　金：2020年济南市卫生健康委员会第二批科技计划(2020-3-58)。

摘　　要：目的探讨急性脑梗死(Acute cerebral infarct, ACI)患者静脉溶栓前后血清中半乳糖凝集素1(Galectin-1,Gal-1)和半乳糖凝集素3(Galectin-3,Gal-3)的水平变化及其临床意义。方法选取接受静脉溶栓的86例ACI患者作为观察组,根据美国国立卫生研究所卒中量表(National institutes of health stroke scale, NIHSS)评分将其分为轻型组31例、中型组29例、重型组26例;治疗结束后随访6个月,根据改良Rankin量表(Modified Rankin scale, mRS)评估预后并分为预后良好组62例和预后不良组24例,根据蒙特利尔认知评估量表(Mentreal congnitive assessment, MoCA)评估认知功能并分为认知障碍(Cognitive impairment, CI)组30例和非认知障碍(Non-cognitive impairment, NCI)组56例。另选30例本院体检健康者作为对照组。应用酶联免疫吸附法测定2组血清Gal-1,Gal-3的水平,分析其与NIHSS,mRS,MoCA的相关性及对静脉溶栓患者预后的预测价值。结果 (1)ACI患者静脉溶栓后血清Gal-1,Gal-3水平较静脉溶栓前逐渐下降,但溶栓后第30 d血清Gal-1水平较溶栓后第7 d升高(P<0.05);(2)ACI患者静脉溶栓前血清Gal-1,Gal-3水平明显高于对照组(P<0.05);重型组Gal-1,Gal-3水平最高,中型组次之,轻型组最低(P<0.05);(3)ACI患者静脉溶栓后第1、7、30 d预后不良组血清Gal-3水平均高于预后良好组(P<0.05),CI组均高于NCI组(P<0.05);溶栓后第30 d预后良好组血清Gal-1水平高于预后不良组(P<0.05),而CI组低于NCI组(P<0.05);其余时间点预后良好组血清Gal-1水平均低于预后不良组(P<0.05),而CI组则高于NCI组(P<0.05);(4)Pearson分析显示,溶栓前血清Gal-1,Gal-3水平与NIHSS评分均呈正相关(r=0.762,0.831,P<0.05);溶栓后第30 d血清Gal-1水平与mRS评分、MoCA评分分别呈负相关、正相关(r=-0.773,0.820,P<0.05);溶栓后第1、7、30 d血清Gal-3水平与mRS评分均呈正相关(r=0.817,0.741,0.675,P<0.05),而与MoCA评分均呈负相关(r=-0.842,-0.763,-0.677,P<0.05);(5)绘制受试者工�Objective To investigate the expression and clinical significance of the levels of galectin-1 and galectin-3 in serum of patients with acute cerebral infarct(ACI) before and after intravenous thrombolysis. Methods 86 patients with ACI who all received intravenous thrombolysis therapy were selected as the observation group they were further divided into the mild subgroup(31 cases), moderate subgroup(29 cases), and severe subgroup(26 cases) according to the NIH Stroke Scale(NIHSS).All the patients with ACI were followed up for 6 months, they were divided into the good prognosis subgroup(62 cases) and poor prognosis subgroup(24 cases)according to the modified Rankin Scale(mRS) score, and also divided into the cognitive impairment subgroup(30 cases) and non-cognitive impairment subgroup(56 cases) according to the Montreal Cognitive Assessment scale(MoCA) score. Another 30 healthy subjects were selected as control group. The levels of galectin-1 and galectin-3 in serum of the two groups were detected by enzyme-linked immunosorbent assay, then the correlations between galectin-1 and galectin-3 expressive levels and NIHSS, mRS, MoCA score were analyzed, and the predictive values of galectin-1 and galectin-3 expressive levels in neurological prognosis were also analyzed.Results(1) Before intravenous thrombolysis, the serum levels of galectin-1 and galectin-3 in the observation group were significantly higher than those in the control group(P<0.05).After intravenous thrombolysis, the levels of galectin-1 and galectin-3 in patients with ACI began to decrease gradually, but the level of galectin-1 on the 30 th day was higher than before.(2) Before intravenous thrombolysis, the levels of galectin-1 and galectin-3 in the severe subgroup were the highest;those in the moderate subgroup were the second;and those in the mild subgroup were the lowest(P<0.05).(3) After intravenous thrombolysis, the levels of galectin-3 in the poor prognosis subgroup were all higher than those in the good prognosis subgroup(P<0.05) on the 1 st day,

关 键 词：半乳糖凝集素1 半乳糖凝集素3 急性脑梗死 预后 认知功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]