Nrf2、PON-1、VILIP-1与急诊脑梗死患者NIHSS评分关系及对溶栓预后预测效能探究  

The relationship between Nrf2,PON-1,VILIP-1 and NIHSS score in emergency cerebral infarction patients and their predictive efficacy on thrombolysis prognosis

作　　者：孟盼 程永琴 MENG Pan;CHENG Yongqin(Emergency Department,Nanjing Pukou District Hospital of Traditional Chinese Medicine,Nanjing Jiangsu 210000,China)

机构地区：[1]南京市浦口区中医院急诊科,江苏南京210000

出　　处：《中国急救复苏与灾害医学杂志》2023年第8期1064-1068,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省优势学科建设工程项目(编号:YSHL0717-37)。

摘　　要：目的探讨核因子E2相关因子2(Nrf2)、对氧磷酯酶-1(PON-1)、视锥蛋白样蛋白-1(VILIP-1)与急诊脑梗死(ACI)患者美国国立卫生研究院卒中量表(NIHSS)评分关系及对溶栓预后预测效能。方法选取2019年1月—2022年8月南京市浦口区中医院收治的160例ACI患者,均给予阿替普酶静脉溶栓,根据溶栓后是否获得血管再通分为再通组(121例)、非再通组(39例),比较两组基线资料、溶栓前和溶栓后6 h Nrf2 mRNA、PON-1、VILIP-1,应用皮尔森(Pearson)分析Nrf2 mRNA、PON-1、VILIP-1与NIHSS评分关系,采用多因素Logistic回归分析溶栓预后的相关影响因素,采用受试者工作特征(ROC)曲线分析Nrf2 mRNA、PON-1、VILIP-1及三者联合预测溶栓预后的效能。结果非再通组溶栓前、溶栓后6 h Nrf2 mRNA、PON-1低于再通组,VILIP-1高于再通组(P<0.05);Nrf2 mRNA、PON-1与NIHSS评分呈负相关,VILIP-1与NIHSS评分呈正相关(P<0.05);将混杂因素控制后,Nrf2 mRNA、PON-1、VILIP-1仍与溶栓预后独立相关(P<0.05);Nrf2、PON-1、VILIP-1的ROC下面积(AUC)分别为0.817、0.734、0.708,三者联合为0.919,三者联合的AUC高于单独指标(P<0.05)。结论Nrf2 mRNA、PON-1、VILIP-1表达与ACI患者神经缺损程度、溶栓预后有关,联合检测溶栓前三者水平,可作为预测溶栓预后的一个有效方案,为临床溶栓治疗提供参考。Objective To investigate the relationship between nuclear factor E2-related factor 2(Nrf2),paraoxonase-1(PON-1),cone-like protein-1(VILIP-1)and National Institutes of Health Stroke Scale(NIHSS)scores in patients with acute cerebral infarction(ACI)and their predictive efficacy for thrombolytic prognosis.Methods One hundred and sixty ACI patients admitted to our hospital from January 2019 to August 2022 were selected and all were given intravenous thrombolysis with alteplase,and were divided into recanalization group(121 cases)and nonrecanalization group(39 cases)according to whether they obtained revascularization after thrombolysis.Baseline data,Nrf2 mRNA,PON-1,VILIP-1 before and 6 h after thrombolysis in both groups were compared,Pearson(Pearson)analysis was applied to analyze the relationship between Nrf2 mRNA,PON-1,VILIP-1 and NIHSS scores,multifactor logistic regression was used to analyze the factors associated with the prognosis of thrombolysis,and subject operating characteristic(ROC)curve to analyze the efficacy of Nrf2 mRNA,PON-1,VILIP-1 and the combination of the three to predict the prognosis of thrombolysis.Results The levels of Glasgow Coma Scale(GCS),Acute Physiology and Chronic Health Evaluation II(APACHE II),Sequential Organ Failure Assessment(SOFA),white blood cell count(WBC),serum creatinine,PCT,CRP,and IL-6 in the sepsis group were significantly higher than those in the control group,while the level of serum albumin was significantly lower than that in the control group(all P<0.05).The expression level of serum miR-16-5p in the sepsis group was significantly higher than that in the control group,while the expression level of miR-96-5p was significantly lower than that in the control group(all P<0.05).The levels of GCS,APACHE II,SOFA,WBC,PCT,CRP,and IL-6 in the patients with high miR-16-5p expression were significantly higher than those with low miR-16-5p expression(all P<0.05).The levels of APACHE II,SOFA,WBC,PCT,CRP,and IL-6 in the patients with high miR-96-5p expression were significantly low

关 键 词：核因子E2相关因子2(Nrf2) 对氧磷酯酶-1(PON-1) 视锥蛋白样蛋白-1(VILIP-1) 急诊 脑梗死 NIHSS评分 溶栓 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]