血清CKLF1与MMP-9联合动态动脉僵硬指数预测急性缺血性脑卒中患者静脉溶栓后出血转化的临床价值  

Clinical value of serum CKLF1,MMP-9 combined with dynamic arterial stiffness index in predicting hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke

作　　者：杨凡[1] 崔东慧 张立铖 贺绚 梁雪原 马军[1] 吕同帅 YANG Fan;CUI Donghui;ZHANG Licheng;HE Xuan;LIANG Xueyuan;MA Jun;LYU Tongshuai(Baoding First Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院,河北保定071000

出　　处：《中国实用神经疾病杂志》2024年第12期1471-1475,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河北省卫生健康委医学科学研究课题计划项目(编号:20191237);保定市科技计划项目(编号:2241ZF053)。

摘　　要：目的探究血清趋化素样因子1(CKLF1)、基质金属蛋白酶9(MMP-9)联合动态动脉僵硬指数(AASI)预测急性缺血性脑卒中(AIS)患者静脉溶栓后出血转化的临床价值。方法选取2021-06—2023-12于保定市第一中心医院进行静脉溶栓治疗的150例AIS患者作为研究组,根据治疗后患者状态分为出血转化组(41例)和非出血转化组(109例),另选取97例同期于我院体检的健康者作为对照组,检测并分析AIS患者血清CKLF1和MMP-9水平以及二者与AASI的相关性,分析影响AIS患者静脉溶栓后出血转化的因素,评估血清CKLF1、MMP-9表达及AASI对AIS患者静脉溶栓后出血转化的预测效能。结果出血转化组和非出血转化组血清CKLF1、MMP-9表达水平和AASI均高于对照组(P<0.05),且出血转化组血清CKLF1、MMP-9表达水平和AASI高于非出血转化组(P<0.05)。血清CKLF1、MMP-9表达水平和AASI两两之间均呈正相关(P<0.05)。出血转化组和非出血转化组年龄和美国国立卫生研究院卒中量表(NIHSS)评分比较,差异具有统计学意义(P<0.05),年龄、NIHSS评分、CKLF1、MMP-9和AASI是AIS患者静脉溶栓治疗发生出血转化的独立危险因素(P<0.05),血清CKLF1、MMP-9、AASI联合预测优于各自单独预测(Z_(联合-CKLF1)=3.917、Z_(联合-MMP-9)=2.942、Z_(联合-AASI)=4.102,P<0.05)。结论血清CKLF1、MMP-9联合AASI对AIS患者静脉溶栓后出血转化具有一定的预测价值。Objective To investigate the clinical value of serum chemokine-like factor 1(CKLF1),matrix metalloproteinase-9(MMP-9)combined with ambulatory arterial stiffness index(AASI)in predicting the hemorrhagic transformation after intravenous thrombolysis in patients with AIS.Methods From June 2021 to December 2023,150 AIS patients who underwent intravenous thrombolysis treatment in Baoding First Central Hospital were regarded as the trail group.According to the patient’s status after treatment,they were divided into the hemorrhagic transformation group(41 cases)and the non-hemorrhagic transformation group(109 cases).Additionally,97 healthy individuals who underwent physical examination in our hospital were regarded as the reference group.The serum levels of CKLF1 and MMP-9 in AIS patients were detected and analyzed,as well as their correlation with AASI.Clinical data of patients were collected and the factors affecting the transformation of bleeding in AIS patients after intravenous thrombolysis were analyzed.The predictive efficacy of serum CKLF1,MMP-9 expressions,and AASI on the transformation of bleeding after intravenous thrombolysis in AIS patients was evaluated.Results The expression levels of serum CKLF1,MMP-9,and AASI in the two groups were higher than those in the reference group(P<0.05),and the expression levels of serum CKLF1,MMP-9,and AASI in the hemorrhagic transformation group were higher than those in the non-hemorrhagic transformation group(P<0.05).The expression levels of serum CKLF1 and MMP-9 were positively correlated with AASI(P<0.05).The difference in age and NIHSS scores between the hemorrhagic transformation group and the non-hemorrhagic transformation group was statistically great(P<0.05).Age,NIHSS score,CKLF1,MMP-9,and AASI were independent risk factors for hemorrhagic transformation in AIS patients undergoing treatment(P<0.05).The combined prediction of serum CKLF1,MMP-9,and AASI was superior to their individual predictions(Z_(combined prediction-CKLF1)=3.917,Z_(combined prediction-MMP-9)=2.9

关 键 词：急性缺血性脑卒中 静脉溶栓 出血转化 趋化素样因子1 基质金属蛋白酶9 动态动脉僵硬指数 

分 类 号：R743.33[医药卫生—神经病学与精神病学]