血清AQP4、GFAP联合检测对急性缺血性脑卒中患者静脉溶栓后出血性转化的预测价值  

Value of Combined Detection of Serum AQP4 and GFAP in Prediction of Hemorrhagic Transformation in Patients with Acute Cerebral Ischemic Stroke after Intravenous Thrombolysis

作　　者：汪文兵 陈后勤 徐钧 邵凌云 左健 WANG Wen-bing;CHEN Hou-qin;XU Jun;SHAO Ling-yun;ZUO Jian(Department of Neurology,the First People's Hospital of Wuhu City,Wuhu,Anhui 241000,China)

机构地区：[1]芜湖市第一人民医院神经内科,安徽芜湖241000

出　　处：《临床误诊误治》2022年第5期102-105,共4页Clinical Misdiagnosis & Mistherapy

基　　金：安徽省科技攻关项目(201702a07327)。

摘　　要：目的探讨血清水通道蛋白4(AQP4)、神经胶质纤维酸性蛋白(GFAP)联合检测对急性缺血性脑卒中患者静脉溶栓后发生出血性转化的预测价值。方法选取2017年8月—2021年6月本院114例急性缺血性脑卒中作为研究组,根据是否发生出血性转化分为转化组和未转化组;另选取同期本院105例体检健康志愿者作为对照组。比较研究组、对照组与转化组和未转化组血清AQP4、GFAP水平;急性缺血性脑卒中患者静脉溶栓后发生出血性转化的影响因素应用非条件多因素Logistic回归分析;血清AQP4、GFAP及联合检测对急性缺血性脑卒中患者静脉溶栓后发生出血性转化的预测价值应用受试者工作特征(ROC)曲线分析。结果研究组血清AQP4、GFAP水平明显高于对照组,转化组明显高于未转化组(P<0.01)。心房颤动、AQP4及GFAP升高为急性缺血性脑卒中患者静脉溶栓后发生出血性转化的危险因素(P<0.01)。以AQP4、GFAP联合检测的曲线下面积最高。结论急性缺血性脑卒中患者静脉溶栓后发生出血性转化患者血清AQP4、GFAP水平上升,AQP4、GFA联合检测对急性缺血性脑卒中患者静脉溶栓后发生出血性转化有一定预测价值。Objective To explore the value of combined detection of serum aquaporin 4(AQP4)and glial fibrillary acidic protein(GFAP)in prediction of hemorrhagic transformation in patients with acute cerebral ischemic stroke(ACIS)after intravenous thrombolysis(IVT).Methods A total of 114 patients with ACIS treated between August 2017 and June 2021 were selected as research group,and the patients were divided into transformation subgroup and non-transformation subgroup according to presence or absence of hemorrhagic transformation.Another 105 healthy volunteers who had undergone physical examinations at the same period were selected as control group.Serum levels of AQP4 and GFAP between research and control groups,and between transformation and non-transformation subgroups were compared.The influencing factors of hemorrhagic transformation after IVT in patients with ACIS were analyzed by using unconditional multivariate logistic regression.Values of serum AQP4,GFAP and combined detection in prediction of hemorrhagic transformation after IVT in patients with ACIS were analyzed by using receiver operating characteristic(ROC)curve.Results Serum levels of AQP4 and GFAP in research group were significantly higher than those in control group,and the levels in transformation subgroup were significantly higher than those in non-transformation subgroup(P<0.01).Atrial fibrillation,elevated AQP4 and GFAP were risk factors for hemorrhagic transformation after IVT in patients with ACIS(P<0.01).The area under the ROC curve of combination detection of AQP4 and GFAP was the highest.Conclusion Serum levels of AQP4 and GFAP are increased in ACIS patients with hemorrhagic transformation after IVT.The combined detection of AQP4 and GFA has some predictive value for hemorrhagic transformation after IVT in patients with ACIS.

关 键 词：卒中 静脉溶栓 出血性转化 水通道蛋白4 神经胶质纤维酸性蛋白 预测价值 

分 类 号：R743[医药卫生—神经病学与精神病学]