急性脑梗死患者血清MECP2、GFAP与病情严重程度及静脉溶栓预后的关系  

Relationship between serum methyl-CpG binding protein 2(MECP2),glial fibrillary acidic protein(GFAP)and severity of disease and prognosis of patients with acute cerebral infarction(ACI)

作　　者：闫雪 张帆 张蕾 张远航 YAN Xue;ZHANG Fan;ZHANG Lei;ZHANG Yuanhang(Department of Emergency,Daxing District People′s Hospital,Beijing 102600,China;Department of Thoracic Surgery,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]大兴区人民医院急诊科,北京102600 [2]北京大学第三医院胸外科,北京100191

出　　处：《新疆医科大学学报》2024年第8期1118-1123,共6页Journal of Xinjiang Medical University

基　　金：北京市科技计划项目(Z21120004011132)。

摘　　要：目的探讨急性脑梗死(Acute cerebral infarction,ACI)患者血清甲基CpG结合蛋白2(MECP2)、神经胶质纤维酸性蛋白(Glial fibrillary acidic protrein,GFAP)与病情严重程度及静脉溶栓预后的关系。方法选取本院收治的ACI患者153例作为研究对象,纳入ACI组,选取同期体检健康人100例作为正常对照组,入组时间为2021年3月-2024年2月,检测两组血清MECP2、GFAP水平。根据美国国立卫生研究院卒中量表(NIHSS)对ACI组患者进行病情严重程度分组。所有患者行静脉溶栓后随访3个月,根据结局不同分为预后良好组(n=96)和预后不良组(n=57)。分析血清MECP2、GFAP水平与病情严重程度及预后的关系。结果与正常对照组比较,ACI组血清MECP2、GFAP水平升高,差异有统计学意义(P<0.05)。与轻度组比较,中/重度组ACI患者血清MECP2、GFAP水平明显升高(P<0.05);与中度组比较,重度组ACI患者血清MECP2、GFAP水平进一步升高(P<0.05)。血清MECP2、GFAP水平与ACI患者病情严重程度呈正相关(r=0.655、0.545,P<0.05)。与预后良好组比较,预后不良组入院NIHSS评分、高血压占比、WBC、LDL-C、hs-CRP及血清MECP2、GFAP均偏高,差异有统计学意义(P<0.05)。多因素Logistic回归模型显示,NIHSS评分和hs-CRP、MECP2、GFAP水平偏高均是导致ACI患者静脉溶栓预后不良的独立危险因素(P<0.05)。ROC曲线显示,血清MECP2、GFAP单独预测ACI患者静脉溶栓预后不良的曲线下面积(AUC)(95%CI)分别为0.736(0.658~0.804)、0.763(0.688~0.828),采用log(P)联合预测AUC(95%CI)为0.852(0.785~0.904),联合预测效能较单独预测效能更好(P<0.05)。结论血清MECP2、GFAP在ACI患者体内水平高表达,其水平变化与病情严重程度呈正相关,是ACI患者静脉溶栓预后不良的影响因素,并且两者联合预测ACI患者预后不良的效能更好。Objective:To investigate the relationship between serum methyl-CpG binding protein 2(MECP2),glial fibrillary acidic protein(GFAP)and the severity of the disease and prognosis of acute cerebral infarction(ACI).Methods:153 ACI patients admitted to the hospital were included in the ACI group,and 100 healthy people in the same period were selected as the normal control group from March 2021 to February 2024.Serum MECP2 and GFAP levels were detected in the 2 groups.The patients in the ACI group were grouped by disease severity according to the National Institutes of Health Stroke Scale(NIHSS).All patients were followed up for 3 months after intravenous thrombolysis,and could be divided into good prognosis group(n=96)and poor prognosis group(n=57)according to different outcomes.The relationship between serum MECP2,GFAP levels and the disease and prognosis was analyzed by statistical methods.Results:Compared with the normal control group,the levels of MECP2 and GFAP in ACI group were significantly higher(P<0.05).Compared with the mild group,the serum MECP2 and GFAP levels in the moderate/severe group were significantly increased(P<0.05);Compared with the moderate group,the serum MECP2 and GFAP levels in the severe group were further increased(P<0.05).The levels of serum MECP2 and GFAP were positively correlated with the severity of ACI(r=0.655,0.545,P<0.05).Compared with the good prognosis group,the admission NIHSS score,the proportion of hypertension,WBC,LDL-C,hs-CRP,serum MECP2 and GFAP in the poor prognosis group were higher,the difference was statistically significant(P<0.05).Multivariate Logistic regression model showed that high NIHSS score and high levels of hs-CRP,MECP2 and GFAP were independent risk factors for poor prognosis of intravenous thrombolysis in ACI patients(P<0.05).ROC curve showed that the area under the curve(AUC)(95%CI)of serum MECP2 and GFAP alone in predicting the poor prognosis of intravenous thrombolytic therapy in ACI patients were 0.736(0.658~0.804)and 0.763(0.688~0.828).The combined predic

关 键 词：急性脑梗死 静脉溶栓 甲基CpG结合蛋白2 神经胶质纤维酸性蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学]