急性缺血性脑卒中患者血清Cav-1和GDF-15表达水平及对预后的评估价值研究  

Expression Levels of Serum Cav-1 and GDF-15 and Their Prognostic Value in Patients with Acute Ischemic Stroke

作　　者：李小琴[1] 余广兰[1] LI Xiao-qin;YU Guang-lan(Department of Neurology,the First People’s Hospital of Yibin,Sichuan Yibin 644000,China)

机构地区：[1]宜宾市第一人民医院神经内科,四川宜宾644000

出　　处：《现代检验医学杂志》2022年第4期118-122,127,共6页Journal of Modern Laboratory Medicine

基　　金：宜兵市卫生健康委员会科研项目(2019352-25)。

摘　　要：目的探讨血清陷窝蛋白-1(Caveolin-1,Cav-1)及生长分化因子-15(growth differentiation factor-15,GDF-15)水平在急性缺血性脑卒中(acute ischemic stroke,AIS)中的表达及对预后的预测价值。方法选取2019年2月~2021年6月宜宾市第一人民医院神经内科收治的156例AIS患者作为观察组,根据美国国立卫生研究院卒中量表(the National Institutes of Health Stroke Scale,NIHSS)评分结果将其分为轻、中、重度组;根据脑梗死面积将其分为腔隙性、中等面积、大面积脑梗死组;根据出院3个月改良Rankin量表(mRS)评分结果将其分为预后良好组和预后不良组。另选取同期进行体检的60例健康者为对照组。比较各组血清Cav-1和GDF-15水平;采用受试者工作特征曲线(ROC)评估血清Cav-1和GDF-15水平对患者预后的预测价值。结果观察组血清Cav-1(22.78±4.54 ng/ml)和GDF-15(790.90±76.75 pg/ml)水平均高于对照组(8.51±2.52 ng/ml,410.51±37.58 pg/ml),差异有统计学意义(t=22.997,36.699,均P<0.05)。重度组、中度组和轻度组血清Cav-1(26.95±5.08 ng/ml,23.22±2.79 ng/ml和18.97±3.29ng/ml)和GDF-15(839.82±96.62pg/ml,806.82±52.01pg/ml和728.45±54.70pg/ml)表达水平依次降低,差异均有统计学意义(F=50.667,33.847,均P<0.05)。大面积梗死组、中等面积梗死组和腔隙性梗死组血清Cav-1(26.91±4.67ng/ml,22.66±2.98 ng/ml和18.95±3.15ng/ml)和GDF-15(847.38±84.92pg/ml,800.64±46.49pg/ml和717.99±54.56 pg/ml)表达水平依次降低,差异均有统计学意义(F=51.550,48.155,均P<0.05)。预后不良组血清Cav-1(25.88±3.69 ng/ml)和GDF-15(828.52±74.32 pg/ml)水平均高于对照组(20.62±3.77 ng/ml,764.74±67.25pg/ml),差异有统计学意义(t=8.658,5.579,均P<0.05)。Pearson相关分析显示,AIS患者血清Cav-1和GDF-15水平与NIHSS评分、脑梗死面积和mRS评分呈正相关(r=0.496~0.715,均P<0.05);ROC曲线表明,血清Cav-1,GDF-15和血清Cav-1+GDF-15预测AIS患者预后的曲线下面积(AUC)为0.847,0.785和0.910,血清CaObjective To investigate the expression of serum Caveolin-1(Cav-1)and growth differentiation factor-15(GDF-15)in acute ischemic stroke(AIS)and its prognostic value.Methods 156 patients with AIS in the First People’s Hospital of Yibin were selected as the observation group.According to the National Institutes of Health Stroke Scale(NIHSS),they were divided into mild,moderate and severe groups.According to the area of cerebral infarction,they were divided into lacunar,medium and large area cerebral infarction groups.According to the modified Rankin Scale(MRS)score of three months after discharge,they were divided into good prognosis group and poor prognosis group.Another 60 healthy persons who underwent physical examination at the same time were selected as the control group.The levels of serum Cav-1 and GDF-15 were compared.Receiver operating characteristic curve(ROC)was used to evaluate the prognostic value of serum Cav-1 and GDF-15 levels.Results The levels of serum Cav-1(22.78±4.54 ng/ml)and GDF-15(790.90±76.75 pg/ml)in the observation group were higher than those in the control group(8.51±2.52 ng/ml,410.51±37.58 pg/ml),the differences were statistically significant(t=22.997,36.699,all P<0.05).There were significant differences in serum Cav-1(26.95±5.08 ng/ml,23.22±2.79 ng/ml,18.97±3.29ng/ml)and GDF-15(839.82±96.62pg/ml,806.82±52.01pg/ml,728.45±54.70pg/ml)decreased successively between severe group,moderate group and mild group the difference were statistically significant(F=50.667,33.847,all P<0.05).There were significant differences in serum Cav-1(26.91±4.67ng/ml,22.66±2.98 ng/ml,18.95±3.15ng/ml)and GDF-15(847.38±84.92pg/ml,800.64±46.49pg/ml,717.99±54.56 pg/ml)decreased successively between large area infarction group,medium area infarction group and lacunar infarction group,the differences were statistically significant(F=51.550,48.155,all P<0.05).The levels of serum Cav-1(25.88±3.69 ng/ml)and GDF-15(828.52±74.32 pg/ml)in the poor prognosis group were higher than those in the good prognos

关 键 词：急性缺血性脑卒中 陷窝蛋白-1 生长分化因子-15 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R392.11[医药卫生—临床医学]