NO/ET-1比值、LDL/ApoB比值与急性缺血性脑卒中后早期神经功能恶化的相关性研究  

Association of nitric oxide/endothelin‑1 ratio and low‑density lipoprotein/apolipoprotein B ratio with early neurological deterioration after acute ischemic stroke

作　　者：喻洪 刘丹 朱伦刚 YU Hong;LIU Dan;ZHU Lungang(Mianyang Hospital Affiliated to Uni-versity of Electronic Science and Technology School of Medicine&Mianyang Central Hospital,Mianyang 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院(绵阳市中心医院),四川绵阳621000

出　　处：《中风与神经疾病杂志》2024年第6期539-543,共5页Journal of Apoplexy and Nervous Diseases

基　　金：四川省卫生健康委员会科研课题(19PJ113)。

摘　　要：目的探讨一氧化氮(NO)/内皮素-1(ET-1)比值、低密度脂蛋白(LDL)/载脂蛋白B(ApoB)比值与急性缺血性脑卒中(AIS)后早期神经功能恶化(END)的相关性。方法回顾性选择2021年3月—2023年3月电子科技大学医学院附属绵阳医院,绵阳市中心医院收治的108例AIS患者临床资料,统计发病24 h内END发生情况。收集实验室数据,计算NO/ET-1比值、LDL/ApoB比值。二元Logistic回归分析影响AIS后END的因素,受试者工作特征(ROC)曲线检验NO/ET-1比值、LDL/ApoB比值对AIS后END的判别价值。结果23例发生END,END组NO/ET-1比值、LDL/ApoB比值均低于非END组(P<0.05)。高入院NHISS评分、糖尿病是AIS后END的危险因素(P<0.05),NO/ET-1比值、LDL/ApoB比值是保护因素(P<0.05)。NO/ET-1比值、LDL/ApoB比值预测AIS后END的曲线下面积分别为0.737、0.753,联合NO/ET-1比值和LDL/ApoB比值预测AIS后END的曲线下面积为0.900,高于单独NO/ET-1比值、LDL/ApoB比值预测(P<0.05)。结论AIS患者NO/ET-1比值、LDL/ApoB比值降低与END发生有关,联合NO/ET-1比值、LDL/ApoB比值可提高对AIS后END的预测价值。Objective To investigate the association of nitric oxide(NO)/endothelin-1(ET-1)ratio and lowdensity lipoprotein(LDL)/apolipoprotein B(ApoB)ratio with early neurological deterioration(END)after acute ischemic stroke(AIS).Methods A retrospective analysis was performed for the clinical data of 108 AIS patients who were admitted to Mianyang Hospital Affiliated to University of Electronic Science and Technology School of Medicine&Mianyang Central Hospital from March 2021 to March 2023,and the incidence rate of END within 24 hours after disease onset was analyzed.Laboratory data were collected to calculate NO/ET-1 ratio and LDL/ApoB ratio.A binary logistic regression analysis was used to analyze the influencing factors for END after AIS,and the receiver operating characteristic(ROC)curve was used to investigate the value of NO/ET-1 ratio and LDL/ApoB ratio in identifying END after AIS.Results END was observed in 23 patients,and the END group had significantly lower NO/ET-1 ratio and LDL/ApoB ratio than the non-END group(P<0.05).High NHISS score on admission and diabetes were risk factors for END after AIS(P<0.05),while NO/ET-1 ratio and LDL/ApoB ratio were protective factors(P<0.05).NO/ET-1 ratio and LDL/ApoB ratio had and area under the ROC curve(AUC)of 0.737 and 0.753,respectively,in predicting END after AIS,and NO/ET-1 ratio combined with LDL/ApoB ratio had an AUC of 0.900 in predicting END after AIS,suggesting that NO/ET-1 ratio combined with LDL/ApoB ratio had a significantly higher AUC than NO/ET-1 ratio or LDL/ApoB ratio alone(P<0.05).Conclusion The reductions in NO/ET-1 ratio and LDL/ApoB ratio in AIS patients are associated with the onset of END,and the combination of NO/ET-1 ratio and LDL/ApoB ratio has a higher value in predicting END after AIS.

关 键 词：急性缺血性脑卒中 早期神经功能恶化 脑血管反应性 一氧化氮 内皮素-1 低密度脂蛋白 载脂蛋白B 

分 类 号：R743.3[医药卫生—神经病学与精神病学]