缺氧诱导因子1α与卵泡抑素样蛋白1对老年急性脑梗死患者功能结局预测价值  

Predictive value of HIF-1αand FSTL1 for functional outcomes of elderly patients with acute cerebral infarction

作　　者：邹诣 郑卜毅 朱鹏磊 Zou Yi;Zheng Buyi;Zhu Penglei(Graduate College,Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang Province,China)

机构地区：[1]浙江中医药大学研究生院,杭州310053 [2]温州市人民医院神经外科

出　　处：《中华老年心脑血管病杂志》2023年第6期621-624,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：温州市科技计划项目(Y2020435)。

摘　　要：目的探讨老年急性脑梗死(ACI)患者卵泡抑素样蛋白1(FSTL1)、缺氧诱导因子1α(HIF-1α)与凋亡分子的表达,对功能结局的预测价值。方法选取2021年6月至2022年6月温州市人民医院收治的220例老年ACI患者作为ACI组,同期200例老年健康体检者作为健康组。ACI患者溶栓治疗后3个月日常生活活动能力量表评分≤60分记为功能结局不良组,>60分记为功能结局良好组。检测所有入组患者血清FSTL1、HIF-1α及相关凋亡分子B淋巴细胞瘤2基因(Bcl-2)和半胱氨酸天冬氨酸蛋白酶3(Caspase-3)表达。结果ACI组血清HIF-1α、FSTL1、Caspase-3表达水平显著高于健康组,Bcl-2表达水平显著低于健康组(P<0.01)。Pearson相关性分析显示,ACI组血清HIF-1α、FSTL1表达水平与Caspase-3呈正相关(P<0.01),与Bcl-2表达水平呈负相关(P<0.01)。多因素logistic回归分析显示,入院美国国立卫生研究院卒中量表评分(OR=1.933,95%CI:1.008~3.705,P=0.047)、发病至治疗时间(OR=2.038,95%CI:1.335~3.112,P=0.001)、HIF-1α(OR=1.865,95%CI:1.202~2.892,P=0.005)和FSTL1(OR=2.160,95%CI:1.142~4.084,P=0.018)是影响老年ACI患者溶栓治疗后功能结局的独立危险因素。HIF-1α和FSTL1联合检测的敏感性(87.9%)和曲线下面积(0.804)显著高于单项检测(P<0.05)。结论HIF-1α、FSTL1可能通过调节凋亡相关蛋白Caspase-3、Bcl-2表达,HIF-1α和FSTL1与神经损伤相关,对于老年ACI患者早期溶栓后功能结局具有预测价值。Objective To investigate the expression of follistatin-like protein 1(FSTL1),hypoxia-inducible factor-1α(HIF-1α)and apoptotic molecules in elderly patients with acute cerebral infarction(ACI),and assess the predictive value of their combined detection.Methods A total of 220 ACI patients admitted to Wenzhou People's Hospital from June 2021 to June 2022 were selected as the ACI group,and 200 healthy individuals taking physical examination during the same period were selected as the health group.The ACI patients with low Activities of Daily Living scale score(≤60)at 3 months after thrombolysis were defined as poor functional outcomes,and those with the score>60 were assigned into good functional outcome group.The expression lev-els of FSTL1 and HIF-1α and apoptosis related molecules,Bcl-2 and Caspase-3 were detected in all the participants.Results The expression levels of HIF-1α,FSTL1 and Caspase-3 were significantly higher,while that of Bcl-2 was obviously lower in the ACI group than the healthy group(P<0.05).Pearson correlation analysis showed that the serum expression levels of HIF-1α and FSTL1 were positively correlated with Caspase-3 level(P<0.01)and negatively with Bcl-2 level in the ACI group(P<0.01).Multivariate logistic regression analysis indicated that the admission NIHSS score(OR=1.933,95%CI:1.008-3.705,P=0.047),time from onset to treatment(OR=2.038,95%CI:1.335-3.112,P=0.001),HIF-1α(OR=1.865,95%CI:1.202-2.892,P=0.005)and FSTL1(OR=2.160,95%CI:1.142-4.084,P=0.018)were independent risk factors affecting the functional outcome of thrombolysis in elderly ACI patients.The sensitivity(87.9%)and AUC(0.804)of combined detection of HIF-1αand FSTL1 were statistically higher than those of single detection(P<0.05).Conclusion HIF-1αand FSTL1 are associated with nerve injury by regulating apoptosis-related proteins Caspase-3 and Bcl-2,and their combined detection has great value for predicting functional outcomes of elderly ACI patients after early thrombolysis.

关 键 词：脑梗死 缺氧诱导因子1 Α亚基 卵泡抑素相关蛋白质类 基因 BCL-2 预测 

分 类 号：R743.33[医药卫生—神经病学与精神病学]