急性缺血性脑卒中患者血清Survivin, Hepc25水平变化及其临床意义  

Changes in serum Survivin and Hepc25 levels in patients with acute ischemic stroke and their clinical significance

作　　者：李海峰[1] 李振华[2] 刘丽娟[1] Li Haifeng;Li Zhenhua;Liu Lijuan(Department of Emergency,the People's Hospital of AnyangCity,Anyang Henan 455000;不详)

机构地区：[1]河南省安阳市人民医院急诊科,455000 [2]河南省安阳市人民医院神经内科,455000

出　　处：《卒中与神经疾病》2022年第5期432-437,共6页Stroke and Nervous Diseases

基　　金：河南省医学科技攻关计划联合共建项目(LHG20191270)。

摘　　要：目的 探讨急性缺血性脑卒中(Acute ischemic stroke, AIS)患者血清生存素(Survivin)、铁调素25(hepcidin 25,Hepc25)水平变化及其临床意义。方法 选取2019年6月-2021年6月安阳市人民医院收治的105例AIS患者为AIS组,另选取同期53例体检健康者为对照组;AIS组入院时根据美国国立卫生研究院卒中量表(National institutes of health stroke scale, NIHSS)评分将AIS组分为轻度缺损组31例、中度缺损组49例、重度缺损组25例,6个月后根据改良Rankin量表评分分为预后不良组42例和预后良好组63例;采用酶联免疫吸附实验(Enzyme linked immunosorbent assay, ELISA)检测血清Survivin, Hepc25水平;Spearman相关系数分析AIS患者血清Survivin, Hepc25水平与NIHSS评分的相关性;多因素Logistic回归分析AIS患者预后不良的影响因素;受试者工作特征(Receiver operating characteristic,ROC)曲线分析血清Survivin, Hepc25水平预测AIS患者预后不良的价值。结果 AIS组血清Survivin, Hepc25水平高于对照组(P<0.05);轻度、中度、重度缺损组血清Survivin, Hepc25水平依次升高(P<0.05)。Spearman相关系数显示,AIS患者血清Survivin, Hepc25水平与NIHSS评分呈正相关(r=0.693、0.764,P均<0.001)。与预后良好组比较,预后不良组年龄更大、体质指数更低、糖尿病的比例、NIHSS评分、Survivin, Hepc25水平更高、发病至入院时间更长(P<0.05)。多因素Logistic回归分析显示,年龄、NIHSS评分、Survivin, Hepc25为AIS患者预后不良的独立危险因素(P<0.05)。受试者工作特征(Receiver operating characteristic,ROC)曲线显示,血清Survivin, Hepc25水平联合预测AIS患者预后不良的曲线下面积>Survivin, Hepc25水平单独预测(P<0.05)。结论 AIS患者血清Survivin, Hepc25水平升高,与神经缺损程度加重和预后不良相关,可作为AIS患者预后不良的预测指标。Objective To investigate the changes of serum survivin and iron-regulating factor 25(Hepc25) levels and clinical significance in patients with acute ischemic stroke(AIS).Methods A total of 105 AIS patients admitted to Anyang People’s Hospital from June 2019 to June 2021 were selected as the AIS group, and another 53 physically healthy people were selected as the control group during the same period. 31 patients in the AIS group were divided into a mild deficit group, 49 patients in the moderate deficit group and 25 patients in the severe deficit group according to the National Institutes of Health Stroke Scale(NIHSS) score at admission. After 6 months, the AIS group was divided into 42 cases in the poor prognosis group and 63 cases in the good prognosis group according to the modified Rankin Scale. Serum Survivin and Hepc25 levels were measured by ELISA. Spearman’s correlation coefficient was used to analyze the correlation between serum Survivin and Hepc25 levels and NIHSS scores in AIS patients, multi-factor logistic regression was used to analyze the factors influencing poor prognosis in AIS patients, and receiver operating characteristic(ROC) curves were used to analyze the value of serum Survivin and Hepc25 levels in predicting poor prognosis in AIS patients.Results Serum Survivin and Hepc25 levels were higher in the AIS group than in the control group(P<0.05). Serum Survivin and Hepc25 levels were sequentially increased in the mild, moderate and severe defect groups(P<0.05). Spearman’s correlation coefficient showed that serum Survivin and Hepc25 levels were positively correlated with NIHSS scores in patients with AIS(r=0.693, 0.764, all P<0.001). The poor prognosis group was older, had a lower body mass index, a higher proportion of diabetes, NIHSS score, Survivin, Hepc25 levels and longer time from onset to admission compared to the good prognosis group(P<0.05). Multi-factor logistic regression analysis showed that age, NIHSS score, Survivin, and Hepc25 were independent risk factors for poor prognos

关 键 词：急性缺血性脑卒中 生存素 铁调素25 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]