急性缺血性脑卒中患者血清Kruppel样转录因子2水平表达与脑梗死体积及预后的相关性研究  

Correlation between the Level of Serum Kruppel-like Transcription Factor 2 and the Volume of Cerebral Infarction and Prognosis in Patients with Acute Ischemic Stroke

作　　者：钟曌 郭继勃 郭昊 韩晓婷 张丽萍 祝刚 ZHONG Zhao;GUO Jibo;GUO Hao;HAN Xiaoting;ZHANG Liping;ZHU Gang(Department of Neurology,the Second Affiliated Hospital of Air Force Medical University,Xi’an 710038,China;Department of Emergency,the Second Affiliated Hospital of Air Force Medical University,Xi’an 710038,China;Department of Neurosurgery,the Second Affiliated Hospital of Air Force Medical University,Xi’an 710038,China;Department of Neurology,Nuclear Industry 417 Hospital,Xi’an 710699,China)

机构地区：[1]空军军医大学第二附属医院神经内科,西安710038 [2]空军军医大学第二附属医院急诊科,西安710038 [3]空军军医大学第二附属医院神经外科,西安710038 [4]核工业四一七医院神经内科,西安710699

出　　处：《现代检验医学杂志》2023年第6期1-5,12,共6页Journal of Modern Laboratory Medicine

基　　金：国家自然科学基金(项目批准号:81903072):外泌体miRNA-1246调控内质网应激凋亡通路在胶质母细胞瘤化疗耐药中的作用和机制研究。

摘　　要：目的 研究急性缺血性脑卒中(acute ischemic stroke,AIS)患者血清Kruppel样转录因子2(kruppel-like factor 2,KLF2)水平表达与脑梗死体积及预后的关系,探讨KLF2对AIS脑梗死体积及预后不良的预测价值,并分析KLF2诱导AIS发生的可能机制。方法 收集2021年4月~2022年11月在空军军医大学第二附属医院收治的141例AIS患者为研究对象,并收集同期行健康体检者50例作为对照。根据Pullicino公式计算AIS脑梗死体积,分为小梗死灶组、中梗死灶组和大梗死灶组;根据改良Rankin量表(modified rankin scale,mRS)评分分为预后良好组和预后不良组;采用Pearson相关性分析血清KLF2表达与AIS患者脑梗死体积、预后及白细胞介素6(interleukin-6,IL-6)、鞘氨醇激酶1(sphingosine kinase 1,SphK1)和鞘氨醇-1-磷酸(sphingosine-1-phosphate,S1P)表达的相关性;绘制ROC曲线评估血清KLF2对AIS预后不良的预测价值。结果 AIS组患者血清KLF2(194.37±32.37pg/ml)水平显著低于对照组(242.85±17.39pg/ml);IL-6(13.70±2.89pg/ml),S1P(432.58±101.37pg/ml)和SphK1(2.65±0.58pg/ml)水平显著高于对照组(9.92±2.45pg/ml,259.15±78.24pg/ml,1.48±0.36 pg/ml),差异具有统计学意义(t=10.076,-8.253,-10.986,-13.367,均P <0.05)。小梗死灶组、中梗死灶组和大梗死灶组血清KLF2水平分别为217.69±33.14pg/ml,196.48±29.53pg/ml和168.94±31.62pg/ml,差异有统计学意义(F=25.753,P<0.001)。AIS预后良好组血清KLF2水平为211.83±28.46pg/ml,明显高于预后不良组的170.12±25.34pg/ml,差异有统计学意义(t=8.982,P<0.001)。血清KLF2水平与AIS脑梗死体积、预后及IL-6,SphK1水平呈负相关性(r=-0.607,-0.586,-0.480,-0.522,均P<0.05),与S1P水平无明显相关性(r=0.172,P>0.05);血清SphK1与S1P水平呈明显正相关(r=0.480,P<0.05)。血清KLF2预测AIS脑梗死体积(中~大梗死灶)和预后不良的AUC值分别为0.871和0.889,当截断值分别取206.1 pg/ml和192.37 pg/ml时,诊断灵敏度和特异度较高。结论 AIS血清中KLF2�Objective To investigate the relationship between serum Kruppel-like transcription factor 2(KLF2)expression and cerebral infarction volume and prognosis in patients with acute ischemic stroke(AIS),explore the predictive value of KLF2 for poor prognosis of AIS,and analyze the possible mechanism of KLF2 in the occurrence of AIS.Methods A total of 141 AIS pa-tients admitted to the Second Affiliated Hospital of the Air Force Military Medical University from April 2021 to November 2022 were collected for the study,and collected 50 healthy individuals who underwent physical examinations during the same period as controls.According to the Pullicino formula,the volume of AIS cerebral infarction was calculated and divided into small infarction group,medium infarction group,and large infarction group.A Pearson correlation analysis was conducted between serum KLF2 expression and cerebral infarct volume,prognosis,interleukin(IL)-6,sphingosine kinase 1(SphK1)and sphingosine-1-phosphate(S1P)expression AIS patients.Draw ROC curve to evaluate the predictive value of serum KLF2 for poor prognosis of AIS.Results The serum KLF2(194.37±32.37pg/ml)levels of AIS patients were significantly lower than those of the control group(242.85±17.39pg/ml),while the levels of IL-6(13.70±2.89pg/ml),S1P(432.58±101.37pg/ml),and SphK1(2.65±0.58pg/ml)were significantly higher than those of the control group(9.92±2.45pg/ml,259.15±78.24pg/ml,1.48±0.36 pg/ml),with statistically significant differences(t=10.076,-8.253,-10.986,-13.367,all P<0.05).The serum KLF2 levels in the small infarction group,the medium infarction group and the large infarction group were 217.69±33.14pg/ml,196.48±29.53pg/ml and 168.94±31.62pg/ml,respectively,and the difference was statistically significant(F=25.753,P<0.001).Serum KLF2 level in AIS group with good prognosis was 211.83±28.46pg/ml,which was significantly higher than that in group with poor prognosis 170.12±25.34pg/ml,and the difference was statistically significant(t=8.982,P<0.001).The serum KLF2 level

关 键 词：急性缺血性卒中 Kruppel样转录因子2 脑梗死体积 白细胞介素6 鞘氨醇激酶1/鞘氨醇-1-磷酸 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R392.11[医药卫生—临床医学]