三种血清标志物在老年急性脑梗死患者中的表达及与短期预后的相关性研究  

Expression of three serum biomarkers in elderly patients with ACI and their correlation with short-term prognosis

作　　者：吕慧艳 郭丽[1] 师艳艳[1] 王燕芳 房娉平[1] Lu Huiyan;Guo Li;Shi Yanyan;Wang Yanfang;Fang Pingping(Department of Neurology,Handan Central Hospital,Handan 056000,Hebei Province,China)

机构地区：[1]邯郸市中心医院神经内五科,056000

出　　处：《中华老年心脑血管病杂志》2023年第7期738-741,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河北省医学科学研究课题(20200456)。

摘　　要：目的探讨血清白细胞介素33(IL-33)、可溶性生长刺激表达基因2蛋白(sST2)、同型半胱氨酸(Hcy)在老年急性脑梗死(ACI)患者中的表达,及其与短期预后的关系。方法选择2020年9月至2022年7月在邯郸市中心医院住院治疗的老年ACI患者80例为病例组和体检健康者85例为对照组。老年ACI患者治疗90d后评估改良Rankin量表(mRS)评分,其中mRS评分≤2分的患者作为预后良好组51例,mRS评分>2分的患者作为预后不良组29例。检测所有受试者血清IL-33、sST2、Hcy水平;分析老年ACI患者短期预后不良的影响因素及血清IL-33、sST2、Hcy水平对老年ACI患者短期预后不良的预测价值。结果病例组血清IL-33、sST2、Hcy水平明显高于对照组(P<0.01)。预后不良组患者血清IL-33、sST2、Hcy水平明显高于预后良好组(P<0.01)。logistic回归分析显示,血清IL-33、sST2、Hcy水平均是影响老年ACI患者短期预后不良的独立危险因素(P<0.01)。血清IL-33、sST2、Hcy、三者联合检测预测老年ACI患者短期预后不良的ROC曲线下面积(AUC)分别为0.788(95%CI:0.669~0.907)、0.826(95%CI:0.729~0.924)、0.803(95%CI:0.698~0.907)、0.955(95%CI:0.898~1.000);三者联合检测的AUC明显高于血清IL-33、sST2、Hcy各自单独的AUC(P<0.05)。结论老年ACI患者血清IL-33、sST2、Hcy水平呈高表达,联合检测三者水平更有利于预测老年ACI患者短期预后。Objective To investigate the expression of serum interleukin-33(IL-33),soluble growth stimulation expressed gene 2 protein(sST2)and homocysteine(Hcy)in elderly patients with acute cerebral infarction(ACI)and their relationship with short-term prognosis.Methods A total of 80 elderly ACI patients admitted in our hospital from September 2020 to July 2022 were selected as the case group,and 85 healthy individuals served as the control group.According to the modified Rankin Scale(mRS)score in 90 d after treatment,the patients with the score≤2 were assigned into favorable prognosis group(51 cases),and with the score>2 into unfavorable prognosis group(29 cases).Serum IL-33,sST2 and Hcy levels were detected in all the subjects.The influencing factors of poor short-term prognosis in elderly ACI patients and the predictive value of serum levels of IL-33,sST2 and Hcy in the prediction were analyzed.Results Serum levels of IL-33,sST2 and Hcy were significantly higher in the case group than the control group(P<0.01),and in the unfavorable prognosis group than the favorable prognosis group(P<0.01).Logistic regression analysis showed that these serum levels were independent risk factors for poor short-term prognosis in elderly ACI patients(P<0.01).The AUC value for predicting poor short-term prognosis in elderly ACI patients with serum IL-33,sST2,and Hcy alone and their combined detection were 0.788(95%CI:0.669-0.907),0.826(95%CI:0.729-0.924),0.803(95%CI:0.698-0.907),and 0.955(95%CI:0.898-1.000),respectively,and the AUC value of combined detection was the highest(P<0.05).Conclusion The serum IL-33,sST2 and Hcy levels are highly expressed in elderly ACI patients.Combined detection of the three indicators is more conducive to predict the short-term prognosis of the patients.

关 键 词：脑梗死 预后 白细胞介素33 高半胱氨酸 数据相关性 危险因素 可溶性生长刺激表达基因2蛋白 

分 类 号：R743.33[医药卫生—神经病学与精神病学]