血清IMA、NFL、Occludin在急性缺血性脑卒中诊断及高压氧疗效预测中的应用价值研究  

Study on the Application Value of Serum IMA,NFL,Occludin in the Diagnosis of Acute Ischemic Stroke and Prediction of the Efficacy of Hyperbaric Oxygen

作　　者：高晓玲 田齐 高继英[1] 刘熙鹏[2] GAO Xiao-ling;TIAN Qi;GAO Ji-ying;LIU Xi-peng(Hyperbaric Oxygen Chamber for Neurosurgery,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Neurosurgery Center,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院神经外科高压氧舱室,河北张家口075000 [2]河北北方学院附属第一医院神经外科,河北张家口075000

出　　处：《解放军医药杂志》2022年第10期16-21,共6页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省2022年度医学科学研究课题计划项目(20220598)。

摘　　要：目的探究血清缺血修饰白蛋白(IMA)、神经丝轻链蛋白(NFL)、闭合蛋白(Occludin)在急性缺血性脑卒中(AIS)诊断及高压氧疗效预测中的应用价值。方法选取2019年5月—2021年12月收治的100例AIS作为观察组,另选取同期体检健康者100例作为对照组。比较2组血清IMA、NFL、Occludin水平,评价血清IMA、NFL、Occludin水平对AIS的诊断价值;比较不同疗效患者临床资料及治疗前、治疗1个疗程后血清IMA、NFL、Occludin水平,分析AIS患者高压氧疗效不良的影响因素,并构建预测模型,评价该模型对疗效不良发生的预测价值。结果观察组血清IMA、NFL、Occludin水平均高于对照组(P<0.01)。血清IMA、NFL、Occludin联合诊断AIS的受试者工作特征曲线下面积最大,为0.907。多因素Logistic回归分析显示,年龄、发病至入院时间、美国国立卫生研究院卒中量表评分及血清IMA、NFL、Occludin治疗前后差值绝对值均为AIS患者高压氧疗效不良的独立影响因素(P<0.01)。列线图模型预测AIS患者高压氧疗效不良相关因素的一致性指数为0.809(95%CI:0.674,0.827),该列线图模型的受试者工作特征曲线下面积为0.784,校正曲线显示列线图模型预测AIS患者高压氧疗效不良发生与实际情况相关性较好,平均绝对误差为0.1。结论AIS患者血清IMA、NFL、Occludin水平明显升高,基于三者构建nomogram预测模型,可有效预测AIS患者高压氧疗效不良,临床通过检测其水平,可用于疾病诊断及疗效预测,为临床治疗提供参考依据。Objective To explore the application value of serum ischemia modified albumin(IMA),neurofilament light-chain(NFL)protein and Occludin in the diagnosis of acute ischemic stroke(AIS)and the prediction of the efficacy of hyperbaric oxygen.Methods In total,100 AIS patients admitted from May 2019 to December 2021 were selected as the observation group,and 100 healthy people undergoing physical examination during the same period were selected as the control group.Serum IMA,NFL and occludin levels were compared between the two groups to evaluate the diagnostic value of serum IMA,NFL and Occludin levels for AIS.The clinical data and the levels of serum IMA,NFL,Occludin before and after one course of treatment in patients with different therapeutic effects were compared,and the influencing factors of poor efficacy of hyperbaric oxygen in AIS patients.A prediction model was constructed to evaluate the predictive value of this model for the occurrence of adverse efficacy.Results The levels of serum IMA,NFL and Occludin in the observation group were higher than those in the control group(P<0.01).The area under the receiver operating characteristic(ROC)curve of combined detection of serum IMA,NFL,and Occludin in the diagnosis of AIS was the largest,which was 0.907.Multivariate logistic regression analysis showed that age,time from onset to admission,NIHSS score and absolute value of serum IMA,NFL,Occludin before and after treatment were independent influencing factors for poor efficacy of hyperbaric oxygen in AIS patients(P<0.01).The consistency index of the nomogram model for predicting the adverse factors related to the efficacy of hyperbaric oxygen in AIS patients was 0.809(95%CI:0.674,0.827).The area under the ROC curve of this nomogram model was 0.784.The correction curve showed that the correlation between the nomogram model had a good correlation with the reality in predicting the poor efficacy of hyperbaric oxygen in AIS patients,with an average absolute error of 0.1.Conclusion The serum IMA,NFL and Occludin levels of

关 键 词：卒中 高压氧 缺血修饰白蛋白 神经丝轻链蛋白 闭合蛋白 诊断 疗效预测 

分 类 号：R743[医药卫生—神经病学与精神病学]