ABCD2评分、PAF、sCD40L、C1q对短暂性脑缺血发作后脑梗死的预测价值及其危险因素分析  

Predictive value of ABCD2 score,PAF,sCD40L,C1q for cerebral infarction after transient ischemic attack and analysis of its risk factors

作　　者：张文超[1] 尹涛 杨雪辉[1] 王睿健 张盟盟 张明哲[1] ZHANG Wenchao;YIN Tao;YANG Xuehui;WANG Ruijian;ZHANG Mengmeng;ZHANG Mingzhe(Department of Neurosurgery,People′s Hospital of Hengshui/Harrison International Peace Hospital in Hengshui,Hengshui,Hebei 053000,China)

机构地区：[1]河北省衡水市人民医院/衡水哈励逊国际和平医院神经外科,河北衡水053000

出　　处：《检验医学与临床》2024年第11期1538-1542,共5页Laboratory Medicine and Clinic

基　　金：河北省科技计划重点研发项目(182777223);河北省衡水市科技计划项目(202201483Z)。

摘　　要：目的探讨ABCD2评分及血清血小板活化因子(PAF)、可溶性CD40配体(sCD40L)、补体1q(C1q)对短暂性脑缺血发作后脑梗死的预测价值。方法回顾性选取2020年11月至2022年12月该院收治的94例短暂性脑缺血发作后脑梗死患者作为脑梗死组,另选取同期收治的146例短暂性脑缺血发作后非脑梗死患者作为非脑梗死组。比较两组临床资料,采用多因素Logistic回归分析短暂性脑缺血发作后脑梗死的危险因素,并绘制受试者工作特征(ROC)曲线分析ABCD2评分及血清PAF、sCD40L、C1q单独及联合检测对短暂性脑缺血发作后脑梗死的预测价值。结果脑梗死组和非脑梗死组颈部血管斑块、发作持续时间、发作频率情况,ABCD2评分及血清PAF、sCD40L、C1q、白细胞介素(IL)-6、超敏C反应蛋白(hs-CRP)水平比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,有颈部血管斑块、发作持续时间≥15 min、发作频率≥2次/月,以及ABCD2评分,血清PAF、sCD40L、C1q、IL-6、hs-CRP水平升高是短暂性脑缺血发作后脑梗死的独立危险因素(P<0.05)。ROC曲线分析结果显示,ABCD2评分及血清PAF、sCD40L、C1q联合预测短暂性脑缺血发作后脑梗死的灵敏度、曲线下面积分别为96.81%、0.927,高于或大于ABCD2评分及血清PAF、sCD40L、C1q单独预测(P<0.05);ABCD2评分、血清PAF单独预测的灵敏度分别高于血清sCD40L、C1q单独预测的灵敏度(P<0.05);ABCD2评分及血清PAF、sCD40L单独预测的特异度高于血清C1q单独、4项指标联合预测的特异度(P<0.05),血清C1q单独预测的特异度高于4项指标联合预测的特异度(P<0.05)。结论短暂性脑缺血发作后脑梗死的发生与患者有颈部血管斑块、发作持续时间≥15 min、发作频率≥2次/月,以及ABCD2评分,血清PAF、sCD40L、C1q、IL-6、hs-CRP水平升高均密切相关,且ABCD2评分及血清PAF、sCD40L、C1q联合检测对短暂性脑缺血发作后脑梗死的预�Objective To investigate the predictive value of score of ABCD2,serum levels of platelet activating factor(PAF),soluble CD40 ligand(sCD40L),complement 1q(C1q)for cerebral infarction after transient ischemic attack and its risk factors.Methods A total of 94 patients with cerebral infarction after transient ischemic attack admitted to the hospital from November 2020 to December 2022 were selected retrospectively as cerebral infarction group,and 146 patients with non-cerebral infarction after transient ischemic attack admitted in the hospital during the same period were selected as the non-cerebral infarction group.The clinical data of the two groups were compared,the risk factors of cerebral infarction after transient ischemic attack were analyzed by multivariate Logistic regression,and the predictive value of alone and combined detection of ABCD2 score,serum PAF,sCD40L,C1q for cerebral infarction after transient ischemic attack was analyzed by receiver operating characteristic(ROC)curve.Results There were significant differences in neck vascular plaque,attack duration,attack frequency,ABCD2 score and serum PAF,sCD40L,C1q,interleukin(IL)-6,high-sensitivity C-reactive protein(hs-CRP)levels between the cerebral infarction group and non-cerebral infarction group(P<0.05).Multivariate Logistic regression analysis showed that neck vascular plaque,attack duration≥15 min,attack frequency≥2 times/month,the increase of ABCD2 score and serum PAF,sCD40L,C1q,IL-6,hs-CRP levels were independent risk factors for cerebral infarction after transient ischemic attack(P<0.05).ROC curve analysis showed that the sensitivity and area under the curve of combined detection of ABCD2 score,serum PAF,sCD40L and C1q in predicting cerebral infarction after transient ischemic attack were 96.81%and 0.927 respectively,which were higher or greater than ABCD2 score,serum PAF,sCD40L,C1q alone prediction(P<0.05).The sensitivity of ABCD2 score and serum PAF alone prediction was higher than serum sCD40L and Cq1 alone prediction,respectively(P<0.05).

关 键 词：短暂性脑缺血发作 脑梗死 ABCD2评分 血小板活化因子 可溶性CD40配体 补体1q 诊断价值 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R446.11[医药卫生—临床医学]