血清Trx1、VILIP-1对急性分水岭脑梗死患者预后不良的预测价值  

The predictive value of serum Trx1 and VILIP-1 for poor prognosis in patients with acute watershed cerebral infarction

作　　者：韩韶 侯艳苹 马岩朋 周涛[1] 祝春燕[3] HAN Shao;HOU Yanping;MA Yanpeng;ZHOU Tao;ZHU Chunyan(Third Department of Neurosurgery,Handan First Hospital,Handan,Hebei 056000,China;Fourth Department of Neurology,Xingtai People′s Hospital,Xingtai,Hebei 054031,China;Skill Center,Handan First Hospital,Handan,Hebei 056000,China)

机构地区：[1]河北省邯郸市第一医院神外三科,河北邯郸056000 [2]河北省邢台市人民医院神经内四科,河北邢台054031 [3]河北省邯郸市第一医院技能中心,河北邯郸056000

出　　处：《检验医学与临床》2024年第13期1880-1884,共5页Laboratory Medicine and Clinic

基　　金：河北省卫健委资助项目(20200185)。

摘　　要：目的探究血清硫氧还蛋白1(Trx1)、视锥蛋白样蛋白-1(VILIP-1)对急性分水岭脑梗死(ACWI)患者预后不良的预测价值。方法选取2019年12月至2022年12月在河北省邯郸市第一医院就诊的126例ACWI患者作为研究对象。收集所有患者的临床资料。检测所有患者甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)水平。根据随访90 d的改良Rankin量表评分将患者分为预后良好组和预后不良组。采用酶联免疫吸附试验检测ACWI患者血清Trx1、VILIP-1水平。采用多因素Logistic回归分析ACWI患者预后不良的影响因素。绘制受试者工作特征(ROC)曲线分析Trx1、VILIP-1单独及2项指标联合检测对ACWI患者预后不良的预测价值。结果随访90 d结果显示,预后良好组患者85例,预后不良组患者41例。预后不良组大面积脑梗死患者比例,美国国立卫生院卒中量表(NIHSS)评分,血清TG、TC、LDL-C水平均明显高于预后良好组,血清HDL-C水平明显低于预后良好组,差异均有统计学意义(P<0.05)。预后不良组血清Trx1水平明显低于预后良好组,血清VILIP-1水平明显高于预后良好组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,NIHSS评分升高、VILIP-1水平升高是ACWI患者预后不良的危险因素(P<0.05),Trx1水平升高是ACWI患者预后不良的保护因素(P<0.05)。ROC曲线分析结果显示,血清Trx1、VILIP-1单独检测预测ACWI患者预后不良的曲线下面积(AUC)分别为0.782、0.814,均低于2项指标联合检测预测ACWI患者预后不良的0.905(Z=2.487、2.350,P<0.05)。结论血清Trx1水平降低和VILIP-1水平升高与ACWI患者预后不良有关,二者均可辅助判断患者预后情况,且二者联合检测对ACWI患者预后不良的预测价值更高。Objective To explore the predictive value of serum thioredoxin 1(Trx1)and cone-like protein-1(VILIP-1)for poor prognosis in patients with acute watershed cerebral infarction(ACWI).Methods A total of 126 ACWI patients who were treated in Handan First Hospital of Hebei Province from December 2019 to December 2022 were selected as the research objects.The clinical data of all patients were collected.The levels of triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and total cholesterol(TC)were detected in all patients.According to the modified Rankin scale score at 90 days of follow-up,the patients were divided into good prognosis group and poor prognosis group.The serum levels of Trx1 and VILIP-1 were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze the risk factors of influencing prognosis in ACWI patients.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of Trx1,VILIP-1 alone and combination of the two indexes for poor prognosis of ACWI patients.Results The 90 days follow-up results showed that there were 85 patients in the good prognosis group and 41 patients in the poor prognosis group.The proportion of patients with massive cerebral infarction,National Institute of Health Stroke Scale(NIHSS)score,serum TG,TC,and LDL-C levels in the poor prognosis group were significantly higher than those in the good prognosis group,and the serum HDL-C level was significantly lower than that in the good prognosis group(P<0.05).The serum Trx1 level of the poor prognosis group was significantly lower than that of the good prognosis group,and the serum VILIP-1 level was significantly higher than that of the good prognosis group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that increased NIHSS score and VILIP-1 level were risk factors for poor prognosis in patients with ACWI(P<0.05),and increased Trx1 level was a protective factor

关 键 词：急性分水岭脑梗死 硫氧还蛋白1 视锥蛋白样蛋白-1 总胆固醇 预测价值 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R446.1[医药卫生—临床医学]