血清骨钙素及SIRT6在急性缺血性脑卒中的表达及预后价值分析  

Analysis of the expression and prognostic value of serum osteocalcin and SIRT6 in acute ischemic stroke

作　　者：何德英[1] 潘成德[2] 郭富饶 江思德[2] He Deying;Pan Chengde;Guo Furao;Jiang Side(Department of Laboratory,People's Hospital of Chongqing Banan District,Chongqing 401320,China;不详)

机构地区：[1]重庆市巴南区人民医院检验科,401320 [2]重庆市巴南区人民医院神经内科,401320

出　　处：《疑难病杂志》2024年第4期435-439,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：重庆市科卫联合医学科研项目(2019MSXM077)。

摘　　要：目的分析急性缺血性脑卒中(AIS)患者血清骨钙素、去乙酰化酶6(SIRT6)表达及其对临床预后的评估价值。方法收集2019年2月—2021年2月重庆市巴南区人民医院神经内科诊治AIS患者90例为AIS组,以同期诊治的高血压或糖尿病患者90例为非AIS组,以同期体检的健康人90例为健康对照组。随访3个月,根据AIS患者预后分为预后不良亚组(n=24)和预后良好亚组(n=66)。利用酶联免疫吸附试验检测血清骨钙素及SIRT6水平。分析AIS患者预后影响因素及血清骨钙素、SIRT6对AIS患者预后评估价值。结果与健康对照组比较,AIS组血清骨钙素、SIRT6水平显著降低(t/P=25.013/<0.001、27.571/<0.001),与非AIS组比较,AIS组显著降低(t/P=31.808/<0.001、36.440/<0.001),健康对照组及非AIS组比较差异无统计学意义(t/P=2.559/0.152、3.113/0.067);重症亚组、中症亚组及轻症亚组AIS患者血清骨钙素及SIRT6依次降低(F/P=15.234/<0.001、30.388/<0.001)。与预后良好亚组比较,预后不良亚组AIS患者梗死面积大、NIHSS评分较高,血清骨钙素及SIRT6较低(χ^(2)/t=8.511、22.826、3.592、3.729,P均<0.001);梗死面积大、NIHSS评分高是影响AIS患者不良预后的独立危险因素[OR(95%CI)=1.397(1.141~1.709)、1.363(1.076~1.728)],血清骨钙素及SIRT6高是影响AIS患者不良预后的独立保护因素[OR(95%CI)=0.770(0.610~0.973)、0.709(0.549~0.915)]。血清骨钙素、SIRT6及两项联合对AIS患者不良预后预测的AUC分别为0.782、0.796、0.886,两项联合的AUC大于各自单独预测效能(Z=4.526、4.209,P均<0.001)。结论AIS患者血清骨钙素、SIRT6降低,两者与AIS病情严重程度有关,可作为评估AIS患者预后的血清生物标志物。Objective To analyze the expression of serum osteocalcin and deacetylase 6(SIRT6)in patients with acute ischemic stroke(AIS)and their evaluation value for clinical prognosis.Methods Ninety AIS patients(AIS group)who treated in the Department of Neurology of People's Hospital Banan District from February 2019 to February 2021 were collected,90 patients with hypertension or diabetes treated at the same time were taken as the disease control group,and 90 healthy individuals were selected as the control group.Following up for 3 months,AIS patients were divided into a poor prognosis group(n=24)and a good prognosis group(n=66)based on their prognosis.Enzyme-linked immunosorbent assay was used to detect serum osteocalcin and SIRT6 levels.Multivariate Logistic regression analysis was used to analyze factors affecting poor prognosis in AIS patients.The evaluation value of various indicators in evaluating the adverse prognosis of AIS patients through receiver operating curve analysis.Results Compared with the healthy control group,the serum levels of osteocalcin and SIRT6 decreased in the AIS group(t/P=25.013/<0.001,27.571/<0.001).Compared with the non AIS group,the AIS group showed a significant decrease(t/P=31.808/<0.001,36.440/<0.001),while there was no statistically significant difference between the healthy control group and the non AIS group(t/P=2.559/0.152,3.113/0.067).The serum osteocalcin and SIRT6 levels in AIS patients in the severe,moderate,and mild subgroups decreased sequentially(F/P=15.234/<0.001,30.388/<0.001).Compared with the subgroup with good prognosis,AIS patients in the subgroup with poor prognosis have larger infarct size,higher NIHSS score,and lower serum osteocalcin and SIRT6(χ^(2)/t=8.511,22.826,3.592,3.729,all P<0.001).Large infarct size and high NIHSS score are independent risk factors for poor prognosis in AIS patients[OR(95%CI)=1.397(1.141-1.709),1.363(1.076-1.728)].Low serum osteocalcin and SIRT6 are independent protective factors affecting the poor prognosis of AIS patients[OR(95%CI)=0.770(

关 键 词：急性缺血性脑卒中 骨钙素 去乙酰化酶6 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]