AIM2、Lp-PLA2、UCH-L1在急性脑梗死中的表达及预测价值研究  

Study on the expression and predictive value of AIM2,Lp-PLA2 and UCH-L1 in acute cerebral infarction

作　　者：张颖[1] 王佳荣 张二娜[1] 赵智江[1] 陈晓艳[3] 刘芳芳[1] ZHANG Ying;WANG Jia-rong;ZHANG Er-na;ZHAO Zhi-jiang;CHEN Xiao-yan;LIU Fang-fang(Department of Neurology,the First Hospital of Baoding City,Hebei Province,Baoding 071000,China;Department of Oncology,Baoding Children′s Hospital,Hebei Province,Baoding 071052,China;Department of Preventive Health Care,the First Hospital of Baoding City,Hebei Province,Baoding 071000,China)

机构地区：[1]河北省保定市第一医院神经内科,河北保定071000 [2]河北省保定市儿童医院肿瘤外科,河北保定071052 [3]河北省保定市第一医院防保科,河北保定071000

出　　处：《河北医科大学学报》2023年第4期386-391,共6页Journal of Hebei Medical University

基　　金：保定市科技计划自筹经费项目(2041ZF242)。

摘　　要：目的 探讨外周血单个核细胞黑色素瘤缺乏因子2(absent in melanoma 2,AIM2)表达,血清脂蛋白相关磷酯酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)、泛素羧基末端水解酶L1(ubiquitin C-terminal hydrolase-L1,UCH-L1)水平与急性脑梗死(acute cerebral infarction,ACI)病情以及神经功能损伤预后的关系,分析AIM2、Lp-PLA2、UCH-L1预测ACI患者神经功能损伤预后的价值。方法 选择我院神经内科收治的150例ACI患者(ACI组)和72例门诊体检志愿者(对照组),根据病灶大小将ACI组分为大梗死组(42例)、小梗死组(61例)、腔隙性梗死组(47例),根据美国国立研究院脑卒中评定量表(National Institute of Stroke Rating Scale,NIHSS)评分分为轻度损伤组(38例)、中度损伤组(59例)、重度损伤组(53例),根据改良RANKIN量表(modified RANKIN scale,MRS)分为预后良好组(91例)、预后不良组(59例)。检测外周血单个核细胞中AIM2表达,血清Lp-PLA2、UCH-L1水平,分析AIM2、Lp-PLA2、UCH-L1预测ACI患者神经功能损伤预后的价值。结果 ACI组外周血单个核细胞AIM2表达,血清Lp-PLA2、UCH-L1水平均高于对照组(P<0.05),且大梗死组高于小梗死组和腔隙性梗死组(P<0.05),重度损伤组高于中度损伤组和轻度损伤组(P<0.05),预后不良组高于预后良好组(P<0.05)。联合AIM2、Lp-PLA2、UCH-L1预测ACI患者神经功能损伤预后的曲线下面积为0.864,高于单独AIM2、Lp-PLA2、UCH-L1单项预测的0.695、0.748、0.692(Z=3.922、2.953、3.983,P<0.05)。结论 ACI患者外周血单核细胞中AIM2表达,Lp-PLA2、UCH-L1水平均增高,且与脑梗死面积、神经缺损程度和不良神经功能损伤预后有关,三者联合在神经功能损伤预后评估中具有较高的价值。Objective To investigate the relationship of the expression of absent in melanoma 2(AIM2)in peripheral blood mononuclear cells(PBMCs),the level of serum lipoprotein-associated phospholipase A2(Lp-PLA2)and ubiquitin C-terminal hydrolase-L1(UCH-L1)with severity of acute cerebral infarction(ACI)and prognosis of neurological impairment.Methods 150 ACI patients treated in Department of Neurology(ACI group)and 72 healthy volunteers undergoing physical examinations(control group)were selected.ACI group was divided into major infarction group(n=42),minor infarction group(n=61),and lacunar infarction group(n=47)according to the size of lesions.ACI group was divided into mild injury group(n=38),moderate injury group(n=59)and severe injury group(n=53)according to the National Institute of Stroke Rating Scale(NIHSS)score.ACI group was divided into good prognosis group(n=91)and poor prognosis group(n=59)according to modified RANKIN scale(MRS)score.The expression of AIM2 in PBMCs,and serum Lp-PLA2 and UCH-L1 levels were detected,to analyze the value of AIM2,Lp-PLA2 and UCH-L1 in predicting the prognosis of neurological impairment in patients with ACI.Results The expression of AIM2 in PBMCs and serum level of Lp-PLA2 and UCH-L1 in ACI group were higher than those in control group(P<0.05),and higher in major infarction group than in small infarction group and lacunar infarction group(P<0.05),in severe injury group than in moderate injury group and mild injury group(P<0.05),and in poor prognosis group than in good prognosis group(P<0.05).The area under the receiver operating characteristic(ROC)curve(AUC)of AIM2,Lp-PLA2 and UCH-L1 in predicting prognosis of neurological impairment in ACI patients was 0.864,which was higher than 0.695,0.748 and 0.692 of AIM2,Lp-PLA2 and UCH-L1 alone(Z=3.922,2.953 and 3.983,P<0.05).Conclusion The expression of AIM2 in PBMCs and the levels of serum Lp-PLA2 and UCH-L1 of ACI patients are increased,which are related to the size of cerebral infarction,the degree of neurological defect and poor prognosis

关 键 词：脑梗死 功能损伤 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]