血清sICAM-1和CysC与缺血性卒中并发脑微出血患者抗血小板治疗疗效的关系  

The Relationship Between Serum Levels of sICAM-1 and CysC and the Efficacy of Antiplatelet Therapy in Patients with Ischemic Stroke Complicated by Cerebral Microbleeds

作　　者：曹迅 谢艳[1] CAO Xun;XIE Yan(Neurology Department,Wujin Hospital of Traditional Chinese Medicine,Wujin,Jiangsu 213000,China)

机构地区：[1]江苏省常州市武进中医医院脑病科(神经内科),江苏武进213000

出　　处：《转化医学杂志》2024年第3期318-322,328,共6页Translational Medicine Journal

基　　金：常州市武进区科技计划项目(WS201826)。

摘　　要：目的 探究血清可溶性细胞间黏附分子-1 (sICAM-1)和胱抑素(Cys) C与缺血性卒中并发脑微出血患者抗血小板治疗疗效的关系。方法 回顾性分析江苏省常州市武进中医医院2018年6月至2019年12月收治的90例缺血性卒中并发脑微出血患者的病历资料,根据抗血小板治疗结果分为转归良好组(66例)和转归不佳组(24例)。比较2组患者血清sICAM-1、CysC水平,分析血清sICAM-1、CysC水平与脑微出血病情严重程度的相关性,评估血清sICAM-1、CysC对缺血性卒中并发脑微出血患者抗血小板治疗疗效的预测价值。结果 转归不佳组血清sICAM-1、CysC水平高于转归良好组(P <0.05)。重度组、中度组、轻度组的血清sICAM-1、CysC水平依次降低,各组间比较差异均有统计学意义(P <0.05)。Spearman相关性分析显示,血清s ICAM-1、Cys C水平二者与脑微出血病情严重程度呈正相关(P <0.05)。受试者工作特征(ROC)曲线分析结果显示,血清sICAM-1、CysC单一及二者联合预测缺血性中并发脑微出血患者抗血小板治疗疗效的曲线下面积(AUC)分别为0.772、0.779、0.873。结论 缺血性卒中并发脑微出血患者血清sICAM-1、CysC水平与病情严重程度呈正相关,且可用于预测抗血小板治疗效果。Objective To explore the relationship between serum soluble intercellular adhesion molecule-1(sICAM-1)and cystatin C(CysC)and the efficacy of antiplatelet therapy in patients with ischemic stroke complicated by cerebral microhemorrhage.Methods A retrospective analysis was performed on the medical records of 90 patients with ischemic stroke complicated by cerebral microhemorrhage,who were admitted to Wujin Hospital of Traditional Chinese Medicine from June 2018 to December 2019.Based on the outcomes of antiplatelet treatment,the patients were divided into a good prognosis group(66 cases)and a poor prognosis group(24 cases).The serum levels of sICAM-1 and CysC were compared between the two groups,and the correlation between serum sICAM-1 and CysC levels and the severity of cerebral microhemorrhage was analyzed.The predictive value of serum sICAM-1 and CysC for the efficacy of antiplatelet therapy in these patients was also assessed.Results The levels of serum sICAM-1 and CysC were higher in the poor prognosis group than in the good prognosis group(P<0.05).In the severe,moderate,and mild groups,the serum levels of sICAM-1 and CysC decreased sequentially,and the differences among these groups were statistically significant(P<0.05).Spearman correlation analysis revealed that serum sICAM-1 and CysC levels were positively correlated with the severity of cerebral microhemorrhage(P<0.05).Receiver operating characteristic(ROC)curve analysis indicated that the areas under the curve(AUC)for serum sICAM-1,CysC,and their combination in predicting the efficacy of antiplatelet therapy were 0.772,0.779,and 0.873,respectively.Conclusion Serum sICAM-1 and CysC levels are positively correlated with the severity of cerebral microhemorrhage in patients with ischemic stroke,and these biomarkers can be used to predict the efficacy of antiplatelet therapy.

关 键 词：缺血性卒中 脑微出血 可溶性细胞间黏附分子-1 胱抑素C 抗血小板治疗 ROC曲线 曲线下面积 数据相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]