血清TRAF6、sTLT-1和血管生成素样蛋白8对急性脑梗死出血性转化的预测效能分析  

Predictive efficacy of serum TRAF6,sTLT-1,and angiopoietin-like protein 8 on hemorrhagic transformation in acute cerebral infarction

作　　者：张三妮 韩淑辉[1] ZHANG Sanni;HAN Shuhui(Department of Neurology,Nanyang First People’s Hospital,Nanyang 473001,China)

机构地区：[1]南阳市第一人民医院神经内科,河南南阳473001

出　　处：《中国医科大学学报》2023年第11期1009-1014,共6页Journal of China Medical University

基　　金：河南科技攻关计划(192102310349)。

摘　　要：目的探讨血清肿瘤坏死因子受体相关因子6(TRAF6)、可溶性骨髓细胞样转录因子-1(sTLT-1)、血管生成素样蛋白8(ANGPTL8)对急性脑梗死(ACI)出血性转化(HT)的预测效能。方法选取我院2019年1月至2021年12月收治的ACI患者118例,于静脉溶栓后3 d复查CT,根据是否发生HT分为发生组与未发生组。比较2组临床资料、溶栓前后血清TRAF6、sTLT-1、ANGPTL8水平及差值,分析各血清差值与HT发生的关系及预测价值。结果发生组溶栓前、溶栓后1 h血清TRAF6、sTLT-1、ANGPTL8水平均高于未发生组(P<0.05);发生组血清TRAF6、sTLT-1、ANGPTL8溶栓前后差值小于未发生组(P<0.05);血清TRAF6、sTLT-1、ANGPTL8溶栓前后差值均与HT的发生独立相关(P<0.05);血清TRAF6、sTLT-1、ANGPTL8溶栓前后差值预测HT发生的曲线下面积(AUC)分别为0.703、0.740和0.689,各指标联合预测AUC为0.920,优于单一指标预测。结论血清TRAF6、sTLT-1、ANGPTL8水平与ACI并发HT具有显著相关性,各指标联合预测ACI并发HT具有较高预测效能,为临床针对性展开后续治疗提供可靠依据。Objective To investigate the predictive efficacy of serum tumor necrosis factor receptor-associated factor 6(TRAF6),soluble myeloid cell-like transcription factor-1(sTLT-1),and angiopoietin-like protein 8(ANGPTL8)in acute cerebral infarction(ACI)hemorrhagic transformation(HT).Methods A total of 118 patients with ACI admitted to our hospital from January 2019 to December 2021 were included in this study,and CT reexamination was performed 3 days after intravenous thrombolysis.They were divided into two groups based on whether HT occurred:the occurrence and non-occurrence groups.The clinical data,serum levels,and differences of TRAF6,sTLT-1,and ANGPTL8 before and after thrombolysis were compared between the two groups,and the relationship between the serum differences and the occurrence of HT and their predictive value were analyzed.Results The serum levels of TRAF6,sTLT-1,and ANGPTL8 in the occurrence group before thrombolysis and 1 h after thrombolysis were higher than those in the non-occurrence group(P<0.05);the difference of serum TRAF6,sTLT-1,and ANGPTL8 before and after thrombolysis in the occurrence group was smaller than that in the non-occurrence group(P<0.05);and the differences of serum TRAF6,sTLT-1,and ANGPTL8 before and after thrombolysis were independently correlated with the occurrence of HT(P<0.05).The area under curve(AUC)predicted by the difference between serum TRAF6,sTLT-1,and ANGPTL8 before and after thrombolysis for the occurrence of HT were 0.703,0.740,and 0.689,respectively;and the joint prediction AUC of all indicators was 0.920,which was better than the single index prediction.Conclusion Serum levels of TRAF6,sTLT-1,and ANGPTL8 are significantly correlated with ACI complicated with HT.The combination of each index has a high predictive performance in predicting ACI complicated with HT,which provides a reliable basis for clinical targeted follow-up treatment.

关 键 词：急性脑梗死 出血性转化 肿瘤坏死因子受体相关因子 可溶性骨髓细胞样转录因子 血管生成素样蛋白 

分 类 号：R743.33[医药卫生—神经病学与精神病学]