血清sCD40L和Galectin-3对急性缺血性脑卒中患者治疗效果及预后的预测价值  

Predictive value of serum sCD40L and Galectin-3 on the therapeutic effect and prognosis of patients with acute ischemic stroke

作　　者：王俊波 武彦霞[2] 郭丹丹 李广[2] WANG Junbo;WU Yanxia;GUO Dandan;LI Guang(Interventional Vascular Surgery,the Second Affiliated Hospital of Xingtai Medical College,Xingtai,Hebei 054000,China;Emergency Department,the Second Affiliated Hospital of Xingtai Medical College,Xingtai,Hebei 054000,China)

机构地区：[1]邢台医学高等专科学校第二附属医院介入血管外科,河北邢台054000 [2]邢台医学高等专科学校第二附属医院急诊科,河北邢台054000

出　　处：《检验医学与临床》2024年第16期2422-2426,共5页Laboratory Medicine and Clinic

基　　金：河北省邢台市重点研发计划项目(2021ZC176)。

摘　　要：目的 探讨血清可溶性CD40配体(sCD40L)和半乳糖凝集素-3(Galectin-3)对急性缺血性脑卒中(AIS)患者治疗效果及预后的预测价值。方法 选取2021年3月至2023年3月该院收治的180例AIS患者作为研究对象,所有患者均接受替耐普酶(TNK-tPA)联合血塞通急救治疗。根据疗效将患者分为有效组和无效组,分别检测并比较两组患者治疗前、治疗4周后的血清sCD40L和Galectin-3水平。所有患者出院后均随访3个月,根据改良RANKIN量表(mRS)评分分为预后良好组和预后不良组。采用多因素Logsitc回归分析影响AIS患者治疗无效及预后不良的危险因素。绘制受试者工作特征(ROC)曲线分析血清Galectin-3、sCD40L对AIS患者治疗无效及预后不良的预测价值。结果 180例研究对象中,治疗有效146例(有效组),无效34例(无效组);预后良好142例(预后良好组),预后不良38例(预后不良组),预后不良发生率为21.11%。治疗4周后,有效组的血清Galectin-3、sCD40L水平均低于无效组(P<0.05)。预后不良组血清Galectin-3、sCD40L水平均高于预后良好组(P<0.05)。多因素Logsitc回归分析结果显示,血清Galectin-3、sCD40L水平升高是影响AIS患者治疗无效及预后不良的危险因素(P<0.05)。ROC曲线分析结果显示,血清Calection-3、sCD40L预测AIS患者治疗无效的曲线下面积(AUC)分别为0.665和0.691,特异度分别为70.08%和77.51%,灵敏度分别为62.53%和62.58%;血清Calection-3、sCD40L联合预测AIS患者治疗无效的AUC为0.784,特异度和灵敏度分别为65.18%和81.25%。血清Galectin-3、sCD40L预测AIS患者预后不良的AUC分别为0.774、0.838,特异度分别为67.58%、75.36%,灵敏度分别为75.06%、80.04%,血清Galectin-3、sCD40L联合预测AIS患者预后不良的AUC为0.919,特异度和灵敏度分别为60.05%和90.63%。结论 血清Galectin-3、sCD40L均对AIS患者的治疗无效和预后不良具有一定的预测效能,且二者指标联合检测可明显提高预测效能。Objective To investigate the predictive value of serum sCD40L and Galectin-3 on the therapeutic effect and prognosis of patients with acute ischemic stroke(AIS).Methods A total of 180 patients with AIS admitted to the hospital from March 2021 and March 2023 were included as study subjects,all of which received rhTNK-tPA combined with Xuesaitong for emergency treatment.The patients were divided into effective group and ineffective group according to the efficacy,and the serum sCD40L and Galectin-3 levels of the two groups were detected and compared before treatment and 4 weeks after treatment,respectively.All patients were followed up for 3 months after discharge from the hospital,and they were divided into good prognosis group and poor prognosis group according to the modified RANKIN scale(mRS)score.Multivariate Logistic regression was used to analyze the risk factors affecting the treatment failure and poor prognosis of AIS patients.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum Galectin-3 and sCD40L on the treatment failure and poor prognosis of AIS patients.Results Among the 180 study subjects,146 cases were treated effectively(effective group)and 34 cases were ineffective(ineffective group).A total of 142 cases had a good prognosis(good prognosis group),and 38 cases had a poor prognosis(poor prognosis group)with poor prognosis incidence rate of 21.11%.After 4 weeks of treatment,serum Galectin-3 and sCD40L levels in the effective group were both obviously lower than those in the ineffective group(P<0.05).Serum Galectin-3 and sCD40L levels in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).Multivariate Logsitc regression analysis showed that increased serum Galectin-3 and sCD40L levels were risk factors affecting the treatment failure and poor prognosis of AIS patients(P<0.05).The results of ROC curve showed that the area under the curve(AUC)of serum Calection-3 and sCD40L for predicting treatment failure in AIS

关 键 词：血清可溶性sCD40配体 血清半乳糖凝集素-3 急性缺血性脑卒中 治疗疗效 预后转归 预测价值 

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