急性脑梗死患者血清NSE、PGE2、LCN2水平及与神经功能缺损程度的关系  

Relationship between the levels of serum NSE,PGE2,LCN2 and the degree of neurological impairment in patients with acute cerebral infarction

作　　者：曲明卫[1] 朱兰 刘亚萍 杨潮萍[1] QU Mingwei;ZHU Lan;LIU Yaping;YANG Chaoping(Department of Neurology,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]河北省沧州市中心医院神经内科,河北沧州061000

出　　处：《检验医学与临床》2024年第23期3515-3519,共5页Laboratory Medicine and Clinic

基　　金：河北省沧州市科技计划自筹经费项目(NO.204106126)。

摘　　要：目的探讨血清神经元特异性烯醇化酶(NSE)、前列腺素-2(PGE2)、脂质运载蛋白2(LCN2)在急性脑梗死(ACI)患者中的水平,以及其与神经功能缺损程度的关系。方法选取2021年6月至2023年1月沧州市中心医院收治的130例ACI患者作为ACI组,根据患者的神经功能缺损程度分为轻度组(n=54)、中度组(n=42)和重度组(n=34);另选取130例与ACI患者临床基本资料一致的同期在该院门诊体检的健康者作为对照组。采用Spearman相关分析ACI患者血清NSE、PGE2、LCN2水平与神经功能缺损程度的相关性;采用多因素Logistic回归分析ACI患者发生中、重度神经功能缺损的影响因素;采用受试者工作特征(ROC)曲线分析血清NSE、PGE2、LCN2对ACI患者发生中、重度神经功能缺损的诊断价值。结果ACI组血清NSE、PGE2、LCN2水平明显高于对照组(P<0.05)。重度组脑梗死体积及血清低密度脂蛋白胆固醇(LDL-C)、NSE、PGE2、LCN2水平显著高于中度组和轻度组(P<0.05);中度组脑梗死体积及血清LDL-C、NSE、PGE2、LCN2水平显著高于轻度组(P<0.05)。Spearman相关分析结果显示,ACI患者血清NSE、PGE2、LCN2水平均与神经功能缺损程度呈正相关(r=0.569,0.687,0.493;均P<0.05)。多因素Logistic回归分析结果显示,血清NSE、PGE2、LCN2、LDL-C水平升高、脑梗死体积增大是ACI患者发生中、重度神经功能缺损的危险因素(P<0.05)。血清NSE、PGE2、LCN2联合诊断ACI患者发生中、重度神经功能缺损的曲线下面积(AUC)为0.920,明显优于NSE、PGE2、LCN2单独诊断的AUC(Z=3.197、3.235、2.887,P<0.05),灵敏度为90.79%,特异度为81.48%。结论ACI患者血清NSE、PGE2、LCN2水平显著升高,且均与神经功能缺损程度呈正相关,三者联合检测对ACI患者发生中、重度神经功能缺损有较好诊断价值。Objective To investigate the levels of neuron specific enolase(NSE),prostaglandin-2(PGE2)and lipocalin 2(LCN2)in the serum of patients with acute cerebral infarction(ACI),and their relationship with the degree of neurological impairment.Methods A total of 130 ACI patients who underwent treatment in Cangzhou Central Hospital from June 2021 to January 2023 were regarded as ACI group,which were subdivided into mild group(n=54),moderate group(n=42)and severe group(n=34)according to the degree of neurological impairment in patients,meanwhile 130 outpatient health checkups in the hospital during the same period,who had the same basic clinical data as the ACI patients,were selected as the control group.Spearman′s correlation was applied to analyze the correlation of serum NSE,PGE2,LCN2 levels with the degree of neurological impairment in ACI patients;multivariate Logistic regression was applied to analyze the influencing factors of moderate and severe neurological deficits occurring in ACI patients;receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum NSE,PGE2 and LCN2 levels for moderate and severe neurological deficits occurring in ACI patients.Results Serum NSE,PGE2 and LCN2 levels in the ACI group were significantly higher than those in the control group(P<0.05).The volume of cerebral infarction,the serum levels of low-density lipoprotein cholesterol(LDL-C),NSE,PGE2 and LCN2 in the severe group were obviously higher than those in the moderate group and the mild group(P<0.05);the infarction volume,the serum levels of LDL-C,NSE,PGE2 and LCN2 in the moderate group were obviously higher than those in the mild group(P<0.05).Spearman′s correlation analysis results showed that serum NSE,PGE2 and LCN2 levels in ACI patients were all positively correlated with the degree of neurological impairment(r=0.569,0.687,0.493;all P<0.05).Multivariate Logistic regression analysis results showed that evaluated levels of serum NSE,PGE2,LCN2 and LDL-C,as well as increased cerebral infarction

关 键 词：神经元特异性烯醇化酶 前列腺素-2 脂质运载蛋白2 急性脑梗死 神经功能缺损程度 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R446.11[医药卫生—临床医学]