血清hs-CRP、TIMP-1及GFAP水平在急性脑梗死患者中的表达及临床意义  

Expression and clinical significance of serum hs-CRP, TIMP-1 and GFAP levels in patients with acute cerebral infarction

作　　者：张玲[1] 薛晓宏 季帮芸 张小建 ZHANG Ling;XUE Xiao-hong;JI Bang-yun(Department of Neurology,Rugao Hospital Affiliated to Nantong University,Rugao People's Hospital,Rugao Jiangsu 226500,China)

机构地区：[1]南通大学附属如皋医院(如皋市人民医院)神经内科,江苏如皋226500

出　　处：《临床和实验医学杂志》2022年第23期2491-2494,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省卫生厅科技计划(编号:20132027)。

摘　　要：目的探究超敏C反应蛋白(hs-CRP)、基质金属蛋白组织抑制因子-1(TIMP-1)及神经胶质纤维酸性蛋白(GFAP)在急性脑梗死患者中的表达与临床意义。方法选取2020年3月至2021年8月在南通大学附属如皋医院治疗的急性脑梗死患者150例行前瞻性研究,根据美国国立卫生研究院卒中量表(NIHSS)评价神经缺损程度,按照NIHSS评分不同将其分为轻度组(NIHSS评分<4分)44例,中度组(NIHSS评分4~15分)60例,重度组(NIHSS评分>15分)34例;按照患者预后不同将其分为预后良好组112例及预后不良组38例。比较不同神经功能缺损程度急性脑梗死患者血清hs-CRP、TIMP-1及GFAP水平;收集患者病例资料,比较不同预后患者血清hs-CRP、TIMP-1及GFAP水平,对不同预后患者资料做单因素分析及多因素Logistic回归分析;采用受试者工作特征(ROC)曲线分析血清hs-CRP、TIMP-1及GFAP预估脑梗死患者预后的价值。结果轻、中、重度3组血清hs-CRP、TIMP-1及GFAP水平比较,差异均有统计学意义(P<0.05);重度组及中度组血清hs-CRP、TIMP-1及GFAP水平均高于轻度组,重度组血清hs-CRP、TIMP-1及GFAP水平均高于中度组,差异均有统计学意义(P<0.05)。治疗前后,预后良好组血清hs-CRP、TIMP-1及GFAP水平均低于预后不良组,差异均有统计学意义(P<0.05)。Logistic多因素回归分析显示,年龄>65岁、并发高血压、并发高血脂、重度梗死、hs-CRP水平≥8 mg/L、TIMP-1水平≥150 ng/mL及GFAP水平≥4 ng/L均是急性脑梗死患者预后不良独立危险因素(P<0.05)。ROC曲线分析显示,血清hs-CRP、TIMP-1及GFAP预估急性脑梗死患者预后有一定诊断价值。结论血清hs-CRP、TIMP-1及GFAP水平与神经功能缺损程度密切相关,能有效预估急性脑梗死患者预后。Objective To explore the expression and clinical significance of high sensitivity C-reactive protein(hs-CRP),tissueinhibitor of metalloproteinase(TIMP-1)and glial fibrillary acidic protein(GFAP)in patients with acute cerebral infarction.Methods A total of 150 patients with acute cerebral infarction treated in Rugao Hospital Affiliated to Nantong University from March 2020 to August 2021 were prospectively selected.According to the National Institutes of Health Stroke Scale(NIHSS)to evaluate the degree of neurological deficit,they were divided into mild group(NIHSS score<4 points)44 cases and moderate group(NIHSS score 4-15 points)60 cases according to different NIHSS scores.34 cases in the severe group(NIHSS score>15).Besides,the patients were divided into good prognosis group 112 cases and poor prognosis group 38 cases according to their prognosis.The levels of serum hs-CRP,TIMP-1 and GFAP in patients with different prognosis were compared;after that,the data of patients with different prognosis was collected,the levels of serum hs-CRP,TIMP-1 and GFAP levels in patients with different prognosis were compared;the factors affecting patients with different prognosis were analyzed using univariate analysis and multivariate logistic regression;and the value of serum hs-CRP,TIMP-1 and GFAP in predicting the prognosis of patients with cerebral infarction was analyzed by receiver pperating characteristic curve(ROC).Results There were significant differences in serum hs-CRP,TIMP-1 and GFAP levels among the mild,moderate and severe groups(P<0.05),the levels of serum hs-CRP,TIMP-1 and GFAP in the severe group and the moderate group were higher than those in the mild group,and the levels of serum hs-CRP,TIMP-1 and GFAP in the severe group were higher than those in the moderate group,the differences were statistically significant(P<0.05).The levels of serum hs-CRP,TIMP-1 and GFAP in the group with good prognosis were lower than those in the group with poor prognosis before or after treatment,the differences were statisticall

关 键 词：急性脑梗死 超敏C反应蛋白 基质金属蛋白组织抑制因子-1 神经胶质纤维酸性蛋白 神经功能缺损程度 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]