血浆Elabela水平预测大血管闭塞型急性缺血性脑卒中患者血管内机械取栓术后近期预后的临床研究  

Plasma Elabela in predicting short-term prognoses in large vessel occlusion-acute ischemic stroke patients accepted endovascular thrombectomy

作　　者：陈浪 李瑞 殷亚美 罗聪 蒿鹏 丰硕 蔡明 孙俊 胡伟 Chen Lang;Li Rui;Yin Yamei;Luo Cong;Hao Peng;Feng Shuo;Cai Ming;Sun Jun;Hu Wei(Department of Neurology,Anhui Provincal Hospital,Anhui Medical University,Hefei 230001,China)

机构地区：[1]安徽医科大学附属省立医院神经内科,合肥230001

出　　处：《中华神经医学杂志》2023年第12期1242-1247,共6页Chinese Journal of Neuromedicine

基　　金："科大新医学"联合基金立项项目(2022)。

摘　　要：目的探讨大血管闭塞型急性缺血性脑卒中(LVO-AIS)患者接受血管内机械取栓术(EVT)后3个月预后和血浆Elabela水平的关系。方法前瞻性选取安徽医科大学附属省立医院神经内科自2020年8月至2022年8月采用EVT治疗的94例LVO-AIS患者。术前、术后24 h和术后72 h采用ELISA法检测患者血浆Elabela水平,术后3个月采用改良Rankin量表(mRS)评估患者的预后。比较预后良好组与预后不良组患者临床资料、血浆Elabela水平的差异,采用多因素Logistic回归分析明确LVO-AIS患者术后3个月预后的独立影响因素,采用受试者工作特征(ROC)曲线分析血浆Elabela水平对LVO-AIS患者术后3个月预后的预测效能。结果与预后不良组比较,预后良好组患者有脑卒中史、糖尿病者占比较低,入院时美国国立卫生研究院卒中量表(NIHSS)评分较低,差异均有统计学意义(P<0.05)。预后良好组患者术后72 h的血浆Elabela水平高于预后不良组患者,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,脑卒中史(OR=0.148,P=0.037,95%CI:0.025~0.889)、糖尿病(OR=0.205,P=0.027,95%CI:0.050~0.836)、高血压(OR=3.488,P=0.024,95%CI:1.177~10.339)、术后72 h Elabela水平(OR=1.064,P=0.005,95%CI:1.019~1.111)是LVO-AIS患者术后3个月预后的独立影响因素。ROC曲线分析显示,术后72 h血浆Elabela水平预测LVO-AIS患者术后3个月预后的ROC曲线下面积(AUC)为0.718(P<0.001,95%CI:0.614~0.822)。结论术后72 h血浆Elabela水平可能是预测LVO-AIS患者EVT术后近期预后的潜在生物标志物。Objective To explore the relation of plasma Elabela with 3-month prognoses in large vessel occlusion-acute ischemic stroke(LVO-AIS)patients accepted endovascular thrombectomy(EVT).Methods A prospective study was performed;94 LVO-AIS patients aceepted EVT in Department of Neurology,Anhui Provincal Hospital,Anhui Medical University from August 2020 to August 2022 were selected.Plasma Elabela was detected before EVT,and 24 and 72 h after EVT.Modified Rankin scale(mRS)was used to evaluate the prognoses of the patients 3 months after EVT;differences in clinical data and plasma Elabela level between the good prognosis group and poor prognosis group were compared.Independent influencing factors for prognoses of LVO-AIS patients 3 months after EVT were analyzed by multivariate Logistic regression.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of Elabela in predicting prognoses of patients with LVO-AIS 3 months after EVT.Results Compared with the poor prognosis group,the good prognosis group had significantly lower percentages of patients with stroke history and diabetes,and lower NIHSS scores at admission(P<0.05).Elabela level in the good prognosis group was significantly higher than that in the poor prognosis group 72 h after EVT(P<0.05).Multivariate Logistic regression analysis showed that stroke history(OR=0.148,P=0.037,95%CI:0.025-0.889),diabetes mellitus(OR=0.148,P=0.037,95%CI:0.025-0.889),hypertension history(OR=3.488,P=0.024,95%CI:1.177-10.339),and Elabela level 72 h after EVT(OR=1.064,P=0.005,95%CI:1.019-1.111)were independent influencing factors for prognoses of LVO-AIS patients 3 months after EVT.ROC curve showed that area under ROC curve of plasma Elabela level 72 h after EVT in predicting prognosies of LVO-AIS patients 3 months after surgery was 0.718(P<0.001,95%CI:0.614-0.822).Conclusion Plasma Elabela level 72 h after EVT may be a potential prognostic biomarker for LVO-AIS patients after EVT.

关 键 词：急性缺血性脑卒中 血管内机械取栓术 Elabela 预后 生物标志物 

分 类 号：R743.3[医药卫生—神经病学与精神病学]