神经丝轻链蛋白水平与急性脑梗死后早期神经功能恶化的相关性  

Correlation between neurofilament light chain level and early neurological deterioration after acute cerebral infarction

作　　者：卿婷 易兴阳[2] 朱亚兰[3] 陈洪[2] 段勇[4] 刘姗 李洁[2] 张萍[2] 曾涛[2] QING Ting;YI Xingyang;ZHU Yalan;CHEN Hong;DUAN Yong;LIU Shan;LI Jie;ZHANG Ping;ZENG Tao(Department of Neurology,the Second People's Hospital of Deyang,Deyang,Sichuan 618000,P.R.China;Department of Neurology,Deyang People's Hospital,Deyang,Sichuan 618000,P.R.China;Department of Neurology,Guanghan People's Hospital,Deyang,Sichuan 618300,P.R.China;Department of Neurology,People's Hospital of Zhongjiang County,Deyang,Sichuan 618100,P.R.China;Department of Neurology,Deyang Jingyang Hospital of T.C.M,Deyang,Sichuan 618000,P.R.China)

机构地区：[1]德阳市第二人民医院神经内科,四川德阳618000 [2]德阳市人民医院神经内科,四川德阳618000 [3]广汉市人民医院神经内科,四川德阳618300 [4]中江县人民医院神经内科,四川德阳618100 [5]德阳市旌阳区中医院神经内科,四川德阳618000

出　　处：《华西医学》2023年第3期403-407,共5页West China Medical Journal

基　　金：德阳市科学技术局科技计划项目(2020SZZ069)。

摘　　要：目的探讨神经丝轻链蛋白(neurofilament light chain,NfL)水平与急性脑梗死(acute cerebral infarction,ACI)后早期神经功能恶化(early neurological deterioration,END)的相关性。方法采用多中心观察性研究的方法,纳入德阳地区4家医院2019年3月31日-2021年7月31日发病72 h内的ACI患者,探讨END发生的危险因素。结果本研究共纳入339例ACI患者,其中女性131例,男性208例,年龄(68.1±11.6)岁。80例患者在入院后7 d内发生END,END发生率为23.6%。未发生END患者的入院美国国立卫生研究院卒中量表评分、NfL水平比发生END患者低(P<0.05)。Cox比例风险模型显示,NfL水平[风险比(hazard ratio,HR)=1.037,95%置信区间(confidence interval,CI)(1.025,1.050),P<0.001]、入院美国国立卫生研究院卒中量表评分[HR=1.202,95%CI(1.127,1.282),P<0.001]、初次血糖[HR=1.068,95%CI(1.006,1.133),P=0.030]与END发生相关。结论NfL水平、卒中严重程度、入院时血糖与ACI患者发生END相关,可尽早采取措施预防END的发生。Objective To explore the relationship between neurofilament light chain(NfL)level and early neurological deterioration(END)after acute cerebral infarction(ACI).Methods The means of multi-center observational study were adopted to include patients with ACI within 72 hours of onset in 4 hospitals in Deyang between March 31,2019 and July 31,2021,to explore the risk factors of END.ResultsA total of 339 patients with ACI were included in this study,including 131 women and 208 men,aged(68.1+11.6)years.END occurred in 80 patients within 7 days after admission,and the incidence of END was 23.6%.The National Institute of Health Stroke Scale score and NfL level of patients without END were lower than those with END(P<0.05).Cox proportional risk model showed that NfL level[hazard ratio(HR)=1.037,95%confidence interval(CI)(1.025,1.050),P<0.001],admission National Institute of Health Stroke Scale score[HR=1.202,95%CI(1.127,1.282),P<0.001],initial blood glucose[HR=1.068,95%CI(1.006,1.133),P=0.030]were related to the occurrence of END.Conclusion The level of NfL,the severity of stroke,and the blood glucose at admission are related to the occurrence of END in patients with ACI.Measures can be taken to control the above problems as soon as possible to prevent the occurrence of END.

关 键 词：急性脑梗死 神经丝轻链蛋白 早期神经功能恶化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]