血清陷窝蛋白-1水平与急性缺血性脑卒中阿替普酶静脉溶栓后出血转化的关系  

Association between serum Caveolin-1 level and hemorrhagic transformation in patients with acute ischemic stroke after intravenous thrombolysis with alteplase

作　　者：杨江胜 朱祖福 沈丽萍 陆如蓝 YANG Jiangsheng;ZHU Zufu;SHEN Liping;LU Rulan(Department of Neurology,Jiangyin Hospital Affiliated to Nantong University,Jiangyin 214400,China)

机构地区：[1]南通大学附属江阴医院神经内科,江苏江阴214400

出　　处：《精准医学杂志》2024年第6期505-508,513,共5页Journal of Precision Medicine

基　　金：南通大学临床医学专项项目基金(2019LY022)。

摘　　要：目的探讨血清陷窝蛋白-1(Caveolin-1)水平与急性缺血性脑卒中(AIS)患者阿替普酶静脉溶栓治疗后出血转化(HT)的关系。方法选择2020年6月—2021年11月我院124例行阿替普酶静脉溶栓治疗的AIS患者,根据其是否发生HT分为HT组(19例)和非HT组(105例),另外选择本院同期健康体检者40例为对照组。收集并比较各组受试者的血清Caveolin-1水平,进一步比较HT组及非HT组患者的性别、年龄、体质量指数、吸烟史、高血压史、糖尿病史、冠心病史、心房颤动史、入院时血压、入院时随机静脉血糖、入院时血清低密度脂蛋白、TOAST分型及基线NIHSS评分等其他临床指标,以logistic回归模型分析AIS患者阿替普酶静脉溶栓后发生HT的相关影响因素。结果HT组、非HT组患者的入院时血清Caveolin-1水平均显著高于对照组受试者(t=10.937、7.873,P<0.05),且HT组患者入院时血清Caveolin-1水平显著高于非HT组(t=6.356,P<0.05);HT组、非HT组患者的年龄、糖尿病史、心房颤动史、入院时随机静脉血糖水平、基线NIHSS评分及TOAST分型患者构成比等指标差异显著(t=2.868、5.721,Z=12.546,P<0.05)。Logistic回归分析发现,患者入院时血清Caveolin-1水平和基线NIHSS评分增高都是阿替普酶静脉溶栓治疗后发生HT的独立危险因素(P<0.05)。结论入院时血清Caveolin-1水平增高是AIS患者阿替普酶静脉溶栓治疗后出现HT的危险因素,其对溶栓后HT的发生具有一定预测价值。Objective To investigate the association between serum Caveolin-1 level and hemorrhagic transformation(HT)in patients with acute ischemic stroke(AIS)after intravenous thrombolysis with alteplase.Methods A total of 124 patients with AIS who underwent intravenous thrombolysis with alteplase in our hospital from June 2020 to November 2021 were enrolled as subjects,and according to the presence or absence of HT,they were divided into HT group with 19 patients and non-HT group with 105 patients.A total of 40 individuals who underwent physical examination during the same period of time were enrolled as control group.Serum Caveolin-1 level was measured and compared between groups,and the HT group and the non-HT group were compared in terms of the clinical indices including sex,age,body mass index,smoking history,hypertension history,diabetes history,coronary heart disease history,atrial fibrillation history,blood pressure on admission,random venous blood glucose on admission,serum low-density lipoprotein on admission,TOAST classification,and baseline NIHSS score.A logistic regression analysis was used to investigate the influencing factors for HT in AIS patients after intravenous thrombolysis with alteplase.Results The HT group and the non-HT group had a significantly higher serum level of Caveolin-1 than the control group on admission(t=10.937,7.873,P<0.05),and compared with the non-HT group,the HT group had a significantly higher serum Caveolin-1 level on admission(t=6.356,P<0.05).There were significant differences between the HT group and the non-HT group in age,diabetes history,atrial fibrillation history,random venous blood glucose on admission,baseline NIHSS score,and the composition ratio of patients with different TOAST classifications(t=2.868,5.721,Z=12.546,P<0.05).The logistic regression analysis showed that the increases in serum Caveolin-1 level on admission and baseline NHISS score were independent risk factors for HT after intravenous thrombolysis with alteplase in AIS patients(P<0.05).Conclusion The incre

关 键 词：窖蛋白1 缺血性卒中 组织型纤溶酶原激活物 血栓溶解疗法 手术后并发症 出血转化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]