血栓弹力图参数联合血清PTX3、sTLT-1对急性脑梗死患者预后不良预测价值  

Predictive value of thromboelastography parameters combined with serum PTX3 and sTLT-1 in predicting poor prognosis of patients with acute cerebral infarction

作　　者：刘桂芳[1] 王薇薇[2] 王峻霞 袁圆 许春香 韩霜[1] LIU Guifang;WANG Weiwei;WANG Junxia;YUAN Yuan;XU Chunxiang;HAN Shuang(Department of Blood Transfusion,Dongtai People's Hospital,Yancheng,Jiangsu 224200,China;Department of Blood Transfusion,Dongtai Traditional Chinese Medicine Hospital,Yancheng,Jiangsu 224200,China;Department of Neurology,Dongtai People's Hospital,Yancheng,Jiangsu 224200,China)

机构地区：[1]东台市人民医院输血科,江苏盐城224200 [2]东台市中医院输血科,江苏盐城224200 [3]东台市人民医院神经内科,江苏盐城224200

出　　处：《检验医学与临床》2024年第17期2557-2563,共7页Laboratory Medicine and Clinic

基　　金：江苏省盐城市医学科技发展计划项目(YK2021084)。

摘　　要：目的探讨血栓弹力图(TEG)参数联合血清正五聚蛋白3(PTX3)、可溶性骨髓细胞样转录因子-1(sTLT-1)对急性脑梗死(ACI)患者预后不良的预测价值。方法选取2020年1月至2023年2月东台市人民医院收治的195例ACI患者为研究对象,采用Rankin修订量表(mRS)评分对治疗后90 d患者预后进行评估,并分为预后良好组(mRS评分为0~2分)和预后不良组(mRS评分为3~5分)。采用美国国立卫生研究院脑卒中评分(NIHSS评分)评估ACI患者神经功能缺损程度,并分为轻度、中度、重度。采用TEG仪检测患者血细胞凝集块形成时间(K)、凝血反应时间(R)、血凝块最大硬度或强度(MA)、凝固角,采用酶联免疫吸附试验检测血清PTX3、sTLT-1水平。采用受试者工作特征(ROC)曲线分析TEG参数联合血清PTX3、sTLT-1对ACI患者预后不良的预测价值,采用De long检验比较曲线下面积(AUC)。采用多因素Logistic回归分析ACI患者预后不良的影响因素。结果根据NIHSS评分评估ACI患者神经功能缺损程度,分为轻度患者(72例)、中度患者(58例)和重度患者(65例)。重度ACI患者血清PTX3、sTLT-1水平高于中度、轻度ACI患者,K、R短于中度、轻度ACI患者,差异均有统计学意义(P<0.05)。中度ACI患者血清PTX3、sTLT-1水平高于轻度ACI患者,K、R短于轻度ACI患者,差异均有统计学意义(P<0.05)。依据mRS评分,ACI患者分为预后良好组(141例),预后不良组(54例)。预后不良组血清PTX3、sTLT-1水平及重度神经功能缺损患者比例高于预后良好组,K、R短于预后良好组,差异均有统计学意义(P<0.05)。多变量方差分析结果显示,在入院时、入院第3天、入院第7天,预后不良组血清PTX3、sTLT-1水平高于预后良好组,K、R短于预后良好组,差异均有统计学意义(P<0.05)。K、R及血清PTX3、sTLT-1水平单独及联合检测预测ACI患者预后不良的AUC分别为0.837、0.838、0.776、0.788、0.928,K、R及血清PTX3、sTLT-1单独预测的AUObjective To explore the predictive value of thromboelastography(TEG)parameters combined with serum pentraxin 3(PTX3)and soluble TERMs like transcript-1(sTLT-1)for poor prognosis in patients with acute cerebral infarction(ACI).Methods A total of 195 patients with ACI admitted to Dongtai People's Hospital from January 2020 to February 2023 were selected as the research objects.The prognosis of patients after treatment 90 days was evaluated by the modified Rankin Scale(mRS)score,and they were divided into the good prognosis group(mRS score was 0-2 points)and the poor prognosis group(mRS score was 3-5 points).The National Institutes of Health Stroke Scale score(NIHSS score)was used to evaluate the degree of neurological deficits in ACI patients,and was classified as mild,moderate and severe.The formation time(K),coagulation reaction time(R),maximum hardness or strength(MA)and coagulation angle of blood clots in patients were measured using a TEG instrument.Serum PTX3 and sTLT-1 levels were detected using enzyme-linked immunosorbent assay.The predictive value of TEG parameters combined with serum PTX3 and sTLT-1 levels on the poor prognosis of ACI patients was analyzed using receiver operating characteristic(ROC)curve,and the area under the curve(AUC)was compared using De long-test.Using multivariate Logistic regression analysis to screen for factors affecting poor prognosis in ACI patients.Results According to the NIHSS score,the degree of neurological deficits in ACI patients was evaluated and divided into mild patients(72 cases),moderate patients(58 cases)and severe patients(65 cases).The serum PTX3 and sTLT-1 levels in severe ACI patients were higher than those in moderate and mild ACI patients,while K and R were shorter than those in moderate and mild ACI patients,and the differences were statistically significant(P<0.05).The serum levels of PTX3 and sTLT-1 in moderate ACI patients were higher than those in mild ACI patients,while K and R were shorter than those in mild ACI patients,and the differences were stat

关 键 词：急性脑梗死 血栓弹力图 正五聚蛋白3 可溶性骨髓细胞样转录因子-1 预后 

分 类 号：R446.9[医药卫生—诊断学]