急性缺血性脑卒中患者血清Tenascin-C、CgA表达与神经功能损伤及预后的相关性  

Correlation Between the Expression of Serum Tenascin-C,CgA and Neurological Dysfunction,Prognosis in Patients with Acute Ischemic Stroke.

作　　者：柴源 齐敏 苏姗姗 马晓亮 邸运涛 Chai Yuan;Qi Min;Su Shanshan(Department of Neurosurgery,Baoding No.4 Central Hospital,Baoding,Hebei 072350,China)

机构地区：[1]保定市第四中心医院神经外科,河北保定072350

出　　处：《四川医学》2024年第11期1225-1229,共5页Sichuan Medical Journal

摘　　要：目的探讨急性缺血性脑卒中(AIS)患者血清腱糖蛋白-C(Tenascin-C)、嗜铬粒蛋白A(CgA)表达与神经功能损伤及预后的相关性。方法收集2021年7月至2023年7月于我院就诊的AIS患者97例作为研究对象(AIS组);选择同期于本院健康体检者99例作为对照组;评估AIS患者神经功能损伤程度,并分为轻度组30例、中度组46例、重度组21例。AIS患者根据预后情况分为预后良好组66例与预后不良组31例。检测血清Tenascin-C、CgA水平。分析患者血清Tenascin-C、CgA水平与美国国立卫生院卒中量表(NHISS)评分的相关性,血清Tenascin-C、CgA表达对AIS患者预后的预测价值,AIS患者预后不良的影响因素。结果AIS组患者血清Tenascin-C高于对照组,血清CgA水平降低(P<0.05);AIS组患者血清Tenascin-C水平随神经功能损伤程度的增加而增加,CgA水平随神经功能损伤的增加而降低(P<0.05);AIS患者血清Tenascin-C与NHISS评分呈正相关,CgA与NHISS评分呈负相关(P<0.05)。预后不良组患者血清Tenascin-C水平及神经功能损伤重度患者比例高于预后良好组,CgA水平低于预后良好组(P<0.05)。ROC曲线结果显示,血清Tenascin-C、CgA水平单独及联合预测AIS患者预后不良的AUC分别为0.806、0.806、0.902,且二者联合诊断优于单独诊断(Z=2.224、2.208,P<0.05)。Tenascin-C和CgA均是AIS患者发生预后不良的影响因素(P<0.05)。结论AIS患者血清Tenascin-C升高、CgA降低与神经功能损伤及预后密切相关,可能成为AIS患者病情评估与预后判断的标志物。Objective To investigate the correlation between the expression of serum Tenascin-C and Chromogranin A(CgA)in patients with acute ischemic stroke(AIS)and neurological function damage,prognosis.Methods A total of 97 AIS patients who visited our hospital from July 2021 to July 2023 were regarded as the study subjects(AIS group);99 healthy individuals who underwent physical examination in our hospital were collected as the reference group;the degree of neurological damage in AIS patients was assessed and they were divided into a mild group of 30 cases,a moderate group of 46 cases,and a severe group of 21 cases based on the scoring results.According to the prognosis,AIS patients were grouped into a good prognosis group of 66 cases and a poor prognosis group of 31 cases.Serum Tenascin-C,CgA levels were detected.Correlation of patients serum Tenascin-C and CgA levels with NHISS scores was analyzed;the predictive value of serum Tenascin-C,CgA expression on the prognosis of AIS patients was analyzed;factors influencing poor prognosis in AIS patients were analyzed.Results Patients in the AIS group had higher serum Tenascin-C than controls and lower serum CgA levels(P<0.05).The level of serum Tenasein-C in AIS group increased with the increase of the degree of neurological impairment,and the level of CgA decreased with the increase of nerve function injury(P<0.05).Serum Tenascin-C in AIS patients was positively correlated with NHISS score,CgA was negatively correlated with NHISS score(P<0.05).The serum Tenascin-C level and the proportion of patients with severe neurological impairment in the poor prognosis group were higher than those in the good prognosis group,while the CgA level was lower than that in the good prognosis group(P<0.05).The ROC curve results showed that the AUC of poor prognosis in AIS patients predicted by serum Tenascin-C and CgA levels alone and in combination was 0.806,0.806,and 0.902,respectively,and the combined diagnosis of the two was superior to the single diagnosis(Z=2.224,2.208,P<0.05).The resul

关 键 词：急性缺血性脑卒中 腱糖蛋白-C 嗜铬粒蛋白A 神经功能损伤 预后 

分 类 号：R743.31[医药卫生—神经病学与精神病学]