血清ITIH4和MCL-1水平与急性缺血性脑卒中患者病情程度及预后的关系  

The serum levels of ITIH4 and MCL-1 in patients with acute ischemic stroke and relationship with the severity and prognosis

作　　者：席俊男 冯松松 薛惠元 腾东 陈丽薇 Xi Junnan;Feng Songsong;Xue Huiyuan;Teng Dong;Chen Liwei(Department of Neurology,Henan University of Science and Technology Affiliated Yellow River Hospital,Henan Province,Sanmenxia 472000,China)

机构地区：[1]河南科技大学附属黄河医院神经内科,河南三门峡472000

出　　处：《疑难病杂志》2024年第4期429-434,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：河南省医学科技攻关计划项目(LHGJ20200763)。

摘　　要：目的探究急性缺血性脑卒中(AIS)患者血清间α胰蛋白酶抑制因子重链4(ITIH4)、髓样细胞白血病因子-1(MCL-1)表达与病情程度及预后的关系。方法纳入2019年7月—2022年7月河南科技大学附属黄河医院神经内科诊治AIS患者128例为AIS组。根据入院时美国国立卫生研究院卒中量表(NIHSS)评分,分为轻度亚组(NIHSS<6分,n=42)、中度亚组(NIHSS 6~<14分,n=52)和重度亚组(NIHSS≥14分,n=34)。根据出院3个月时AIS患者改良Rankins评分,分为预后不良亚组(mRS评分>2分,30例)和预后良好亚组(mRS评分≤2分,98例)。另选取同期医院体检的健康人70例为健康对照组。酶联免疫吸附试验检测血清ITIH4、MCL-1水平。Pearson相关分析血清ITIH4、MCL-1水平与病情程度及预后的相关性;多因素Logistic回归分析影响AIS患者预后的因素;受试者工作特征曲线分析血清ITIH4、MCL-1对AIS患者预后的预测价值。结果AIS组患者血清ITIH4、MCL-1水平显著低于健康对照组(t/P=43.211/<0.001,43.191/<0.001);病情程度越重,AIS患者血清ITIH4/MCL-1水平越低(F/P=107.796/<0.001,297.976/<0.001);预后不良亚组梗死面积、入院24 h NIHSS评分高于预后良好亚组(t/P=9.637/<0.001,9.752/<0.001),血清ITIH4、MCL-1水平及出院3个月简易智能状态量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分低于预后良好亚组(t/P=26.723/<0.001,11.709/<0.001,13.674/<0.001,10.782/<0.001);AIS患者血清ITIH4、MCL-1与梗死面积、入院24 h NIHSS评分呈负相关(r/P=-0.705/<0.001,-0.685/<0.001;-0.761/<0.001,-0.619/<0.001),与出院3个月MMSE评分、MoCA评分呈正相关(r/P=0.656/<0.001,0.632/<0.001;0.751/<0.001,0.789/<0.001);出院3个月MMSE评分高、出院3个月MoCA评分高是影响AIS患者预后不良的独立保护因素[0.622(0.446~0.868),0.606(0.427~0.861)],血清ITIH4低、MCL-1低、梗死面积大、入院24 h NIHSS评分高是危险因素[OR(95%CI)=1.467(1.150~1.870),1.415(1.094~1.829),1.605(1.168~2.205),1.765(1.233~Objective To investigate the relationship between the expression of serum inter alpha trypsin inhibitor heavy chain 4(ITIH4),myeloid cell leukemia sequence 1(MCL-1)and disease severity and prognosis in patients with acute ischemic stroke(AIS).Methods A total of 128 patients diagnosed and treated with AIS in the Department of Neurology of Henan University of Science and Technology Affiliated Yellow River Hospital from July 2019 to July 2022 as AIS group.According to the National Institutes of Health Stroke Scale(NIHSS)score at admission,the patients were divided into mild subgroup(NIHSS<6 points,n=42),moderate subgroup(6 points≤NIHSS<14 points,n=52),and severe subgroup(NIHSS≥14 points,n=34).According to the modified Rankins score of AIS patients at 3 months of discharge,they were divided into poor prognosis subgroup(score>2 points,30 cases)and good prognosis subgroup(score≤2 points,98 cases).A total of 70 healthy individuals who underwent physical examinations in hospitals during the same period were selected as the healthy group.Enzyme linked immunosorbent assay was used to detect serum levels of ITIH4 and MCL-1.Pearson correlation analysis was conducted to investigate the correlation between serum levels of ITIH4 and MCL-1 with the severity and prognosis of the disease;Multivariate Logistic regression analysis was used to identify the factors that affect the prognosis of AIS patients;The predictive value of serum ITIH4 and MCL-1 for the prognosis of AIS patients was analyzed by receiver operating characteristic curves.Results The serum levels of ITIH4 and MCL-1 in AIS patients were lower than those in the healthy group(t/P=43.211/<0.001,43.191/<0.001).The more severe the illness,the lower the serum levels of ITIH4 and MCL-1 in AIS patients(F/P=107.796/<0.001,297.976/<0.001).The infarction area and 24-hour NIHSS score of the poor prognosis group were higher than those of the good prognosis group(t/P=9.637/<0.001,9.752/<0.001),while serum ITIH4 and MCL-1 levels,3-month Mini Intelligence State Scale(MMSE)scor

关 键 词：急性缺血性脑卒中 间α胰蛋白酶抑制因子重链4 髓样细胞白血病因子-1 病情程度 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]