血TG/HDL-C、PECAM-1、IL-19联合检测预测短暂性脑缺血发作患者近期发生急性脑梗死的价值  

Value of combined detection of blood TG/HDL-C,PECAM-1,and IL-19 in predicting the recent occurrence of acute cerebral infarction in patients with transient ischemic attack

作　　者：杜迎春[1] 高延伦 侯兵兵 姚鸣鸣 DU Ying-chun;GAO Yan-lun;HOU Bing-bing;YAO Ming-ming(Cerebrovascular Disease Ward,the First People's Hospital of Pingdingshan City,Pingdingshan 467000,Henan,CHINA)

机构地区：[1]平顶山市第一人民医院脑血管病病区,河南平顶山467000

出　　处：《海南医学》2024年第21期3075-3080,共6页Hainan Medical Journal

基　　金：2022年河南省医学科技攻关联合共建项目(编号:LHGJ20221969)。

摘　　要：目的探讨联合检测血甘油三酯(TG)/高密度脂蛋白胆固醇(HDL-C)、血小板内皮细胞黏附分子1(PECAM-1)、白介素-19(IL-19)预测短暂性脑缺血发作(TIA)患者近期发生急性脑梗死(ACI)的价值。方法选取2021年2月至2023年7月平顶山市第一人民医院收治的353例TIA患者进行前瞻性研究,根据6个月内是否发生ACI分为ACI组(n=46)和无ACI组(n=307)。比较两组患者的基线资料及治疗前的血TG/HDL-C、PECAM-1、IL-19水平,采用多因素Logistic回归分析TG/HDL-C、PECAM-1、IL-19对TIA近期发生ACI的影响,采用受试者工作特征(ROC)曲线分析TG/HDL-C、PECAM-1、IL-19、年龄、血压、临床症状、糖尿病和持续的时间评分(ABCD3-I)预测TIA患者近期发生ACI的效能,DeLong检验比较TG/HDL-C+PECAM-1+IL-19与ABCD3-I评分的ROC曲线下面积(AUC)。结果ACI组患者的TIA发作次数、颈动脉和颅内动脉有不稳定斑块患者占比、ABCD3-I评分分别为(4.82±1.52)次、45.65%(21/46)、23.91%(11/46)、(6.86±1.24)分,明显高于无ACI组患者的(2.00±0.61)次、29.32%(90/307)、13.68%(42/307)、(4.64±0.95)分,差异均有统计学意义(P<0.05)。ACI组患者的TG/HDL-C、PECAM-1、IL-19分别为1.23±0.12、(11.42±2.36)mg/L、(82.44±17.35)ng/L,明显高于无ACI组患者的1.08±0.10、(8.99±2.64)mg/L、(67.28±19.00)ng/L,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,校正了TIA发作次数、颈动脉有不稳定斑块、颅内动脉狭窄情况、ABCD3-I评分后,TG/HDL-C、PECAM-1、IL-19仍是TIA近期发生ACI独立相关危险因素(P<0.05)。ROC分析结果显示,TG/HDL-C、PECAM-1、IL-19预测TIA近期发生ACI的AUC分别为0.812、0.792、0.798;TG/HDL-C、PECAM-1联合IL-19的AUC为0.930,大于ABCD3-I评分的0.830(P<0.05);三者联合的预测敏感度为93.48%,特异度为81.43%。结论血TG/HDL-C、PECAM-1、IL-19是TIA近期发生ACI的独立相关因素,与ABCD3-I评分相比,联合检测三者预测TIA近期发生ACI风险的价值较高,Objective To explore the value of combined detection of blood triglyceride(TG)/high-density lipoprotein cholesterol(HDL-C),platelet endothelial cell adhesion molecule-1(PECAM-1),and interleukin-19(IL-19)in predicting the recent occurrence of acute cerebral infarction(ACI)in patients with transient ischemic attack(TIA).Methods A prospective study was conducted on 353 patients with TIA admitted to the First People's Hospital of Pingdingshan from February 2021 to July 2023.The patients were divided into ACI group(n=46)and non-ACI group(n=307)according to whether ACI occurred within 6 months.The baseline data and the levels of blood TG/HDL-C,PECAM-1,and IL-19 before treatment were compared between the two groups.The effects of TG/HDL-C,PECAM-1,and IL-19 on the recent occurrence of ACI in patients with TIA were analyzed by multivariate logistic regression.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of TG/HDL-C,PECAM-1,IL-19,and the Age,Blood Pressure,Clinical Features,Duration,and Diabetes plus Dual TIA(ABCD3-I)score in predicting the recent occurrence of ACI in patients with TIA.The DeLong test was used to compare the areas under the ROC curves(AUC)between TG/HDL-C+PECAM-1+IL-19 and ABCD3-I scores.Results The number of TIA episodes,the proportion of patients with unstable plaques in carotid and intracranial arteries,and the ABCD3-I score in the ACI group were(4.82±1.52)times,45.65%(21/46),and 23.91%(11/46),and(6.86±1.24)points,respectively,which were significantly higher than(2.00±0.61)times,29.32%(90/307),13.68%(42/307),and(4.64±0.95)points in the non-ACI group,respectively(P<0.05).The TG/HDL-C,PECAM-1,and IL-19 levels in the ACI group were 1.23±0.12,(11.42±2.36)mg/L,and(82.44±17.35)ng/L,re-spectively,which were significantly higher than 1.08±0.10,(8.99±2.64)mg/L,and(67.28±19.00)ng/L in the non-ACI group(P<0.05).After adjusting for the number of TIA episodes,multifactorial logistic regression analysis showed that presence of unstable carotid plaque,intracranial artery steno

关 键 词：甘油三酯/高密度脂蛋白胆固醇 血小板内皮细胞黏附分子1 白介素-19 短暂性脑缺血发作 急性脑梗死 

分 类 号：R743.31[医药卫生—神经病学与精神病学]