血小板反应蛋白1及水通道蛋白9与急性缺血性脑卒中近期预后的关系  

Relationship between TSP1 and AQP9 with short-term outcomes in acute ischemic stroke patients

作　　者：戴晶 王兴梅 Dai Jing;Wang Xingmei(Department of Neurology,First Affiliated Hospital of Xinjiang Medical University Changji Branch,Changji 831100,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学第一附属医院昌吉分院神经医学科,831100 [2]石河子市人民医院老年病科

出　　处：《中华老年心脑血管病杂志》2022年第4期400-403,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：新疆维吾尔自治区自然科学基金(2021D01A179)。

摘　　要：目的探讨急性缺血性脑卒中(AIS)患者血小板反应蛋白1(TSP1)及水通道蛋白9(AQP9)水平与近期预后的相关性及其预测价值。方法选取2017年8月~2020年8月新疆医科大学第一附属医院昌吉分院收治的AIS患者184例,均随访3个月,失访2例,最终纳入182例,并根据改良的Rankin量表(mRS)评分分为预后良好组135例和预后不良组47例,测血清TSP1和AQP9水平,用logistic回归分析和Pearson相关性分析,用ROC曲线评估预测价值。结果预后不良组年龄>70岁(63.83%vs 28.89%)、重度神经功能缺损程度(48.94%vs 20.74%)比例、血清TSP1[(251.73±47.84)μg/Lvs(203.33±51.84)μg/L]和AQP9[(31.49±6.63)μg/Lvs(24.98±7.06)μg/L]水平明显高于预后良好组(P<0.01)。logistic回归分析显示,年龄>70岁(OR=5.903,95%CI:1.398~24.932)、重度神经功能缺损程度(OR=7.560,95%CI:2.211~25.851)、TSP1(OR=1.021,95%CI:1.011~1.031)、AQP9(OR=1.153,95%CI:1.076~1.236)是AIS患者近期预后不良的危险因素(P<0.05,P<0.01)。Pearson相关分析显示,TSP1和AQP9水平与mRS评分均呈正相关(r=0.549、0.540,P<0.05)。ROC曲线分析显示,TSP1、AQP9和两项联合预测AIS患者近期预后的曲线下面积分别为0.764、0.750和0.868,敏感性分别为66.0%、78.7%和87.2%,特异性分别为79.3%、62.2%和82.2%。结论TSP1和AQP9可作为评估AIS患者近期预后的潜在生物标志物。Objective To study the relationship between thrombospondin-1(TSP1) and aquaporin-9(AQP9) expression levels with short-term outcomes in acute ischemic stroke(AIS) patients.Methods One hundred and eighty-four AIS patients admitted to our hospital from August 2017 to August 2020 were followed up for 3 months with 2 patients missed their follow-up.The remaining 182 AIS patients were divided into good outcome group(n=135) and poor outcome group(n=47) according to their mRS score.Their TSP1 and AQP9 expression levels were measured.The relationship of TSP1 and AQP9 expression levels with mRS score in AIS patients was analyzed by logistic regression analysis and Pearson correlation analysis respectively.The value of TSP1 and AQP9 expression levels for predicting the short-term outcomes in AIS patients was evaluated by ROC curve analysis.Results The ratio of age >70 years and severe neurological deficit, the expression levels of TSP1 and AQP9 were significantly higher in poor outcome group than in good outcome group(63.83% vs 28.89%,48.94% vs 20.74%,251.73±47.84 μg/L vs 203.33±51.84 μg/L,31.49±6.63 μg/L vs 24.98±7.06 μg/L,P<0.01).Logistic regression analysis showed that age>70 years, severe neurological deficit, TSP1 and AQP9 were risk factors for the short-term poor outcomes in AIS patients(OR=5.903,95%CI:1.398-24.932;OR=7.560,95%CI:2.211-25.851;OR=1.021,95%CI:1.011-1.031;OR=1.153,95%CI:1.076-1.236;P<0.05;P<0.01).Pearson correlation analysis displayed that TSP1 and AQP9 expression levels were positively related with the short-term outcomes in AIS patients(r=0.549,0.540,P<0.05).ROC curve analysis revealed that the AUC of TSP1,AQP9 and combined TSP1 and AQP9 for predicting the short-term outcomes in AIS patients was 0.764,0.750 and 0.868 respectively with a sensitivity of 66.0%,78.7% and 87.2% respectively and a specificity of 79.3%,62.2% and 82.2% respectively.Conclusion TSP1 and AQP9 can be used as potential biomarkers in evaluating the short-term outcomes in AIS patients.

关 键 词：凝血酶敏感蛋白1 水孔蛋白质类 卒中 动脉粥样硬化 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]