血清PON-1、IL-17A水平与急性缺血性脑卒中神经功能缺损程度及短期预后的关系  

Relationships between serum PON-1 and IL-17A levels and the degree of neurological impairment and short-term prognosis after acute ischemic stroke

作　　者：杨广智 王燕飞 李华亮[2] 陈思聪 YANG Guangzhi;WANG Yanfei;LI Hualiang;CHEN Sicong(Department of Laboratory Medicine,Yancheng Third People's Hospital,Yancheng 224001,China;不详)

机构地区：[1]盐城市第三人民医院检验科,江苏盐城224001 [2]盐城市第三人民医院神经内科

出　　处：《山东医药》2023年第34期11-15,共5页Shandong Medical Journal

基　　金：江苏省卫生健康委项目(JH19158)。

摘　　要：目的探讨血清对氧磷酶-1(PON-1)、白细胞介素-17A(IL-17A)水平与急性缺血性脑卒中(AIS)神经功能缺损程度及短期预后的关系。方法选择132例AIS患者(AIS组)和52例健康志愿者(对照组)。根据美国国立卫生研究院卒中量表(NIHSS)评分将AIS患者分为轻度组(42例)、中度组(53例)和重度组(37例),根据发病90 d改良Rankin量表(m RS)评分将AIS患者分为预后不良组(39例)和预后良好组(93例)。检测血清PON-1、IL-17A水平,收集临床资料。多因素Logistic回归分析影响AIS患者短期预后的因素。受试者工作特征(ROC)曲线分析血清PON-1、IL-17A预测AIS患者短期预后的价值。结果AIS组血清PON-1水平低于对照组(P<0.05),IL-17A水平高于对照组(P<0.05)。重度组血清PON-1水平低于轻度组和中度组(P均<0.05),IL-17A水平高于轻度组和中度组(P均<0.05)。预后不良组血清PON-1水平低于预后良好组(P<0.05),IL-17A水平高于预后良好组(P<0.05)。入院时高NIHSS评分、高水平IL-17A是AIS患者短期预后不良的危险因素(P均<0.05),高水平PON-1是保护因素(P<0.05)。PON-1、IL-17A预测AIS患者短期预后的ROC曲线下面积(AUC)为0.798、0.795,联合预测的AUC为0.953,联合预测的AUC高于单独指标预测(P均<0.05)。结论AIS患者血清PON-1水平降低,IL-17A水平增高,二者水平异常与神经缺损程度加重及短期预后不良有关;可作为预测AIS患者短期预后的指标。Objective To investigate the relationships between serum levels of paraoxonase-1(PON-1)and interleu⁃kin-17A(IL-17A)and the degree of neurological impairment and short-term prognosis in acute ischemic stroke(AIS).Methods Totally 132 AIS patients(AIS group)and 52 healthy volunteers(control group)were selected.According to the National Institutes of Health Stroke Scale(NIHSS)score,AIS patients were divided into the mild group(42 cases),moderate group(53 cases),and severe group(37 cases);according to the modified Rankin Scale(mRS)score on the 90 d of onset,AIS patients were divided into the poor prognosis group(39 cases)and good prognosis group(93 cases).Se⁃rum PON-1 and IL-17A levels were detected and clinical data were collected.Multivariate Logistic regression analysis was used to analyze the factors affecting the short-term prognosis of AIS patients.The value of PON-1 and IL-17A in predicting short-term prognosis of AIS patients was analyzed by receiver operating characteristic(ROC)curve.Results The serum PON-1 level in the AIS group was lower than that in the control group(P<0.05),and IL-17A level was higher than that in the control group(P<0.05).Serum PON-1 level was lower in the severe group than in the mild and moderate groups(both P<0.05),and IL-17A level was higher than those in the mild and moderate groups(both P<0.05).The level of serum PON-1 in the poor prognosis group was lower than that in the good prognosis group(P<0.05),and the level of IL-17A was higher than that in the good prognosis group(P<0.05).High NIHSS score and high level of IL-17A at admission were risk factors for poor short-term prognosis in AIS patients(both P<0.05),and high level of PON-1 was protective factor(P<0.05).The AUC of PON-1 and IL-17A in predicting the short-term prognosis of AIS patients was 0.798 and 0.795,and the AUC of them combined was 0.953,which was higher than that of either alone(both P<0.05).Conclusion Serum PON-1 level decreases and IL-17A level increases in AIS patients,which is associated with the aggravation

关 键 词：急性缺血性脑卒中 神经功能缺损 短期预后 对氧磷酶-1 白细胞介素-17A 

分 类 号：R743[医药卫生—神经病学与精神病学]