急性脑梗死患者介入取栓术围术期PPAR-γ、FAR、ENA-78水平变化与预后的关系  

Relationship between PPAR-γ,FAR,ENA-78 levels and prognosis in patients with acute cerebral infarction during perioperative period of interventional thrombolectomy

作　　者：李菲菲[1] 马冬璞[2] 牛金朵 朱小倩 LI Fei-fei;MA Dong-pu;NIU Jin-duo;ZHU Xiao-qian(CNICU,Zhengzhou Central Hospital,Zhengzhou 450000,Henan,CHINA;Department of Neurological Severity,Zhengzhou Central Hospital,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州市中心医院CNICU,河南郑州450000 [2]郑州市中心医院神经重症,河南郑州450000

出　　处：《海南医学》2023年第17期2443-2448,共6页Hainan Medical Journal

基　　金：河南省高等学校重点科研项目(编号:15A320018)。

摘　　要：目的探讨急性脑梗死(ACI)患者介入取栓术围术期过氧化小体增殖剂激活型受体γ(PPAR-γ)、纤维蛋白原/白蛋白比值(FAR)、中性粒细胞激活肽-78(ENA-78)水平变化与预后的关系。方法选取2020年1月至2022年11月郑州市中心医院收治的134例ACI患者为研究对象,所有患者均接受介入取栓术,根据术后3个月改良Rankin量表(mRS)评分分为对照组78例(mRS评分≤2分)和观察组56例(mRS评分>2分),根据术前美国国立卫生研究院卒中量表(NIHSS)评分分为轻度损伤51例(NIHSS<4分)、中度损伤43例(NIHSS评分4~20分)和重度损伤40例(NIHSS评分>20分),根据颅脑电子计算机断层扫描(CT)检查的脑梗死面积分为大面积梗死39例、中面积梗死57例和小面积梗死38例。比较不同神经损伤程度、不同梗死面积患者术前血清PPAR-γ、FAR、ENA-78水平,采用Pearson线性相关法分析术前血清PPAR-γ、FAR、ENA-78水平与NIHSS评分及梗死面积相关性,比较不同预后患者术前、术后1周、术后2周血清PPAR-γ、FAR、ENA-78水平,采用受试者工作特征曲线(ROC)分析其联合检测对ACI患者预后不良的预测价值及危险度。结果术前,轻度神经损伤患者的血清PPAR-γ水平(329.85±21.07)pg/mL>中度损伤(275.73±16.41)pg/mL>重度损伤(218.62±18.44)pg/mL,轻度神经损伤患者的FAR、ENA-78水平[89.46±11.37、(103.28±11.64)ng/L]<中度损伤[126.75±15.63、(142.95±13.39)ng/L]<重度损伤[168.34±14.79、(193.08±16.64)ng/L],差异均有统计学意义(P<0.05);术前,小面积梗死患者的血清PPAR-γ水平(334.14±19.57)pg/mL>中面积梗死(269.53±15.81)pg/mL>大面积梗死(237.60±16.42)pg/mL,小面积梗死患者的血清FAR、ENA-78水平[92.35±10.61、(95.46±12.86)ng/L]<中面积梗死[121.49±12.34、(139.55±14.08)ng/L]<大面积梗死[163.67±11.58、(196.33±13.37)ng/L],差异均有统计学意义(P<0.05);术前,血清PPAR-γ水平与NIHSS评分(r=-0.715)、梗死面积(r=-0.633)呈负相关(P<0.05),FAR�Objective To investigate the relationship between peroxysome proliferator-activated receptor γ(PPAR-γ),fibrinogen/albumin ratio(FAR),and neutrophil activating peptide-78(ENA-78)levels and prognosis in patients with acute cerebral infarction(ACI)during perioperative period of interventional thrombolectomy.Methods A total of 134 ACI patients who admitted to Zhengzhou Central Hospital from January 2020 to November 2022 and underwent interventional thrombectomy were selected and divided into a control group(78 patients,mRS score≤2 points)and an observation group(56 patients,mRS score>2 points)based on the modified Rankin Scale(mRS)score at 3 months after surgery.According to the preoperative National Institutes of Health Stroke Scale(NIHSS)score,51 patients were classified as mild injury(NIHSS<4 scores),43 cases as moderate injury(NIHSS score 4~20 points),and 40 cases as severe injury(NIHSS score>20 scores).Based on the cerebral infarction area by brain electronic computed tomography(CT),the 134 patients were divided into 39 cases of large area infarction,57 cases of medium area infarction,and 38 cases of small area infarction.The preoperative serum levels of PPAR-γ,FAR,and ENA-78 were compared among patients with different degrees of nerve injury and different infarct sizes.Pearson linear correlation method was used to analyze the correlation between preoperative serum levels of PPAR-γ,FAR,and ENA-78 and NIHSS score and infarct size.The serum levels of PPAR-γ,FAR,and ENA-78 were compared among patients with different prognosis before surgery,1 week after surgery,and 2 weeks after surgery.The predictive value and risk of the combined detection of the three indexes for poor prognosis in ACI patients were analyzed by receiver operating characteristic curve(ROC).Results Before surgery,the serum PPAR-γ levels were decreased successively in patients with mild injury of(329.85±21.07)pg/mL,moderate injury of(275.73±16.41)pg/mL,and severe injury of(218.62±18.44)pg/mL,while the FAR and ENA-78 levels were increased

关 键 词：急性脑梗死 介入取栓术 过氧化小体增殖剂激活型受体γ 纤维蛋白原/白蛋白比值 中性粒细胞激活肽-78 预后 相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]