血清sCD40L、PTX3及GFAP在急性脑梗死患者中的变化及对病情、预后的评估作用  

Changes of Serum Soluble CD40L,PTX3 and GFAP in Patients with Acute Cerebral Infarction and Their Values in Evaluating Disease Condition and Prognosis

作　　者：潘阿莉 方无杰 洪亮[2] 杨时 PAN A-li;FANG Wu-jie;HONG Liang;YANG Shi(The Second Department of Encephalopathy,Lu'an Hospital of Traditional Chinese Medicine,Lu'an,Anhui 237000,China;the First Department of Encephalopathy,Lu'an Hospital of Traditional Chinese Medicine,Lu'an,Anhui 237000,China;the Third Department of Internal Medicine,Lu'an Hospital of Traditional Chinese Medicine,Lu'an,Anhui 237000,China)

机构地区：[1]六安市中医院脑病内二科,安徽六安237000 [2]六安市中医院脑病内一科,安徽六安237000 [3]六安市中医院内三科,安徽六安237000

出　　处：《解放军医药杂志》2022年第5期111-114,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：安徽省科技攻关类计划项目(1701041136)。

摘　　要：目的分析血清可溶性CD40L(sCD40L)、正五聚蛋白3(PTX3)及神经胶质纤维酸性蛋白(GFAP)在急性脑梗死患者中的变化及对病情、预后的评估价值。方法选取本院2017年10月—2021年7月本院收治的139例急性脑梗死作为脑梗死组,另选取同期本院收治的91例周围性眩晕作为眩晕组。对比2组sCD40L、PTX3及GFAP水平,同时观察不同病情、预后急性脑梗死患者sCD40L、PTX3及GFAP水平变化,并分析影响急性脑梗死患者预后的因素及上述因子与急性脑梗死病情、预后的相关性。结果脑梗死组sCD40L、PTX3及GFAP显著高于眩晕组(P<0.01)。急性脑梗死患者随着病情严重程度的增加sCD40L、PTX3及GFAP水平逐渐增高(P<0.05)。预后良好组sCD40L、PTX3及GFAP低于预后不良组(P<0.01)。sCD40L、PTX3及GFAP是急性脑梗死患者预后的影响因素(P<0.01)。急性脑梗死患者sCD40L、PTX3及GFAP与美国国立卫生研究院率中量表评分呈正相关(r=0.692、0.806、0.774,P<0.01),与改良Rankin量表评分呈正相关(r=0.618、0.546、0.572,P<0.05)。结论sCD40L、PTX3及GFAP在急性脑梗死中高表达,且与患者神经损伤及预后明显相关,上述因子联合检测可作为评估患者病情、预后的参考指标。Objective To analyze changes of serum soluble CD40L(sCD40L),pentraxins 3(PTX3)and glial fibrillary acidic protein(GFAP)in patients with acute cerebral infarction(ACI)and their values in evaluating disease condition and prognosis.Methods A total of 139 patients with ACI admitted between October 2017 and July 2021 were selected as cerebral infarction group,and other 91 patients with peripheral vertigo at the same period were selected as vertigo group.Levels of sCD40L,PTX3 and GFAP were compared between two groups,and changes of sCD40L,PTX3 and GFAP in ACI patients with different conditions and prognoses were observed,and then factors affecting prognoses with ACI and correlations between the above factors with patients'conditions and prognoses of ACI patients were analyzed.Results Levels of sCD40L,PTX3 and GFAP in cerebral infarction group were significantly higher than those in vertigo group(P<0.01).Levels of sCD40L,PTX3 and GFAP were increased gradually with increasing severity of ACI(P<0.05).Levels of sCD40L,PTX3 and GFAP in good prognosis group were significantly lower than those in poor prognosis group(P<0.01).The sCD40L,PTX3 and GFAP were influencing factors affecting prognoses of patients with ACI(P<0.01).The sCD40L,PTX3 and GFAP in ACI patients were positively correlated with National Institutes of Health Stroke Scale score(r=0.692,0.806,0.774,P<0.01),and modified Rankin scale score(r=0.618,0.546,0.572,P<0.05).Conclusion The sCD40L,PTX3 and GFAP are highly expressed in ACI patients,and are significantly correlated with nerve injury and prognosis.The combined detection of these factors can be used as a reference index to evaluate conditions and prognoses of patients.

关 键 词：脑梗死 可溶性CD40L 正五聚蛋白3 神经胶质纤维酸性蛋白 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]