血清炎症因子和S100B与进展性脑梗死患者神经功能缺损、梗死体积及预后的相关性研究  

Correlation between serum inflammatory factors and S100B and neurological deficit,infarct volume and prognosis in patients with progressive cerebral infarction

作　　者：方文[1] 陈桢 李鹏飞 卓开全 FANG Wen;CHEN Zhen;LI Peng-fei(Department of Laboratory Medicine,Suining Hospital of Traditional Chinese Medicine,Suining Sichuan 629000,China)

机构地区：[1]遂宁市中医院检验科,四川遂宁629000 [2]遂宁市中医院神经内科,四川遂宁629000

出　　处：《临床和实验医学杂志》2023年第14期1469-1474,共6页Journal of Clinical and Experimental Medicine

基　　金：四川省卫生健康委员会科研课题(编号:20PJ281)。

摘　　要：目的探讨血清炎症因子和S100钙结合蛋白B(S100B)与进展性脑梗死患者神经功能缺损、梗死体积及预后的相关性。方法回顾性选择2021年1月至12月遂宁市中医院收治住院治疗的急性脑梗死患者96例,根据入院后病情恶化情况将其分为进展性脑梗死组(n=43)和非进展性脑梗死组(n=53)。根据入院时国立卫生研究院卒中量表NIHSS评分不同将进展性脑梗死患者分为轻度神经功能缺损组(n=8,<4分)、中度神经功能缺损组(n=21,4~15分)、重度神经功能缺损组(n=14,>15分)。根据梗死体积不同将进展性脑梗死患者分为大梗死灶组(n=6,>10 cm^(3))、纳入中梗死灶组(n=14,4~10 cm^(3))、小梗死灶组(n=23,<4 cm^(3))。根据将改良Rankin量表(mRS)评分不同将进展性脑梗死患者分为预后良好组(n=32,<3分)、预后不良组(n=11,3~6分)。测定血清炎症因子[超敏C反应蛋白(hs-CRP)、白细胞(WBC)、中性粒细胞(NEU)]和S100B水平,分析血清炎症因子和S100B与进展性脑梗死患者神经功能缺损程度、梗死体积以及预后的关系。计算受试者工作特征曲线下面积(AUC),分析上述指标对进展性脑梗死诊断以及患者预后的预测价值。结果进展性脑梗死组血清hs-CRP、WBC、NEU以及S100B水平均显著高于非进展性脑梗死组,差异均有统计学意义(P<0.05)。hs-CRP、WBC、NEU以及S100B预测进展性脑梗死的AUC均大于0.5,4项联合检测预测进展性脑梗死的敏感度、特异度、AUC分别为69.49%、78.34%、0.856,高于单项预测效能(P<0.05)。随着神经功能缺损加重、梗死体积增大,进展性脑梗死患者血清hs-CRP、WBC、NEU以及S100B水平均显著升高,差异均有统计学意义(P<0.05)。预后不良组进展性脑梗死患者血清hs-CRP、WBC、NEU以及S100B水平均显著高于预后良好组,差异均有统计学意义(P<0.05)。hs-CRP、WBC、NEU、S100B与进展性脑梗死患者神经功能缺损程度、梗死体积呈显著正相关,与预后呈�Objective To investigate the correlation between serum inflammatory factors and S100 calcium binding protein B(S100B)and neurological deficit,infarct volume and prognosis of patients with progressive cerebral infarction.Methods A total of 96 patients with acute cerebral infarction who were hospitalized in Suining Hospital of Traditional Chinese Medicine from January 2021 to December 2021 were retrospectively selected,and were divided into progressive cerebral infarction group(n=43)and non-progressive cerebral infarction group(n=53)according to the deterioration of their condition after admission.According to the different(national institute of health stroke scale)NIHSS scores at admission,patients with progressive cerebral infarction were divided into mild neurological deficit group(n=8,<4 points),moderate neurological deficit group(n=21,4-15 points),and severe neurological deficit group(n=14,>15 points).According to the different infarct volumes,patients with progressive cerebral infarction were divided into a large infarct group(n=6,>10 cm^(3)),a moderate infarct group(n=14,4-10 cm^(3)),and a small infarct group(n=23,<4 cm^(3)).According to the different modified Rankin scale(mRS)scores,patients with progressive cerebral infarction were divided into a good prognosis group(n=32,<3 points)and a poor prognosis group(n=11,3-6 points).Serum inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),white blood cells(WBC),neutrophil(NEU)]and S100B levels were measured,and the relationship between serum inflammatory factors and S100B and neurological deficit,infarct volume and prognosis of patients with progressive cerebral infarction was analyzed.The receiver operating characteristic area under curve(AUC)was calculated,and the predictive value of the above indexes for the diagnosis of advanced cerebral infarction and the prognosis of patients was analyzed.Results The levels of serum hs-CRP,WBC,NEU and S100B in progressive cerebral infarction group were significantly higher than those in non-progressive cerebral

关 键 词：进展性脑梗死 炎症因子 S100B 神经功能缺损 梗死体积 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]