脑梗死后痴呆患者血清sFas、MMP-9、Ang1-7水平变化及预测预后的价值分析  

Changes of serum sFas,MMP-9,Ang1-7 levels and their prognostic value in patients with demen aaftercerebral infarction

作　　者：杨帆 Yang Fan;Tang Xueli;Zhang Dujuan(Yima Coal Industry Group Co.,Ltd.General Hospital Henan Yima 472300)

机构地区：[1]义马煤业集团股份有限公司总医院,河南义马472300

出　　处：《辽宁医学杂志》2024年第6期61-64,共4页Medical Journal of Liaoning

摘　　要：目的 探讨脑梗死后痴呆患者血清可溶性凋亡相关因子(sFas)、基质金属蛋白酶-9(MMP-9)、血管紧张素1-7(Ang1-7)水平变化及预测预后的价值。方法 选取2021年1月—2023年1月我院收治的脑梗死后痴呆患者90例,纳入痴呆组,根据2∶1选例原则,另选取同期脑梗死后无痴呆患者45例,纳入对照组。比较2组血清sFas、MMP-9、Ang1-7水平,比较不同病情程度脑梗死后痴呆患者血清各指标水平,比较不同预后患者血清各指标水平,分析血清各指标水平联合检测对预后不良的预测价值。结果 痴呆组血清sFas、MMP-9水平高于对照组,血清Ang1-7水平低于对照组(P<0.05);不同病情程度患者血清sFas、MMP-9水平比较:轻度<中度<重度,血清Ang1-7水平比较:轻度>中度>重度(P<0.05);预后不良患者血清sFas、MMP-9水平高于预后良好患者,血清Ang1-7水平低于预后良好患者(P<0.05);血清sFas、MMP-9、Ang1-7水平联合预测脑梗死后痴呆患者预后不良的AUC为0.879,最佳预测敏感度、特异度分别为90.32%、84.75%,约登指数为0.751。结论 脑梗死后痴呆患者血清sFas、MMP-9表达上调,Ang1-7表达下调,各指标水平与病情严重程度相关,联合检测对预后不良具有一定预测价值,可作为临床判断病情、评估预后的辅助指标。Objective To investigate the changes of serum levels of soluble apoptosis-related factors(sFas),matrix metalloproteinase-9(MMP-9)and angiotensin 1-7(Angl-7)in patients with dementia after cerebral infarction and their prog-nostic value.Methods A total of 90 patients with dementia after cerebral infarction admitted to our hospital from January 2021 to January 2023 were included in the dementia group,and 45 patients without dementia after cerebral infarction during the same period were included in the control group.The serum levels of sFas,MMP-9 and Ang1-7 were compared between the two groups,and the serum levels of various indexes in patients with dementia after cerebral infarction and patients with different prognosis were compared,and the predictive value of combined detection of serum indexes for poor prognosis was analyzed.Results The serum sFas and MMP-9 levels in dementia group were higher than those in control group,and the serum Angl-7 levels were lower than those in control group(P<0.05).The serum sFas and MMP-9 levels in patients with dfferent disease degrees were compared:mild<moderate<severe,and serum Angl-7 levels were compared:mild>moder-ate>severe(P<0.05).Serum sFas and MMP-9 levels in patients with poor prognosis were higher than those in patients with good prognosis,and serum Angl-7 levels were lower than those in patients with good prognosis(P<0.05).The AUC of sFas,MMP-9 and Angl-7 combined prediction of poor prognosis in patients with dementia after cerebral infarction was 0.879,the best prediction sensitivity and specificity were 90.32%and 84.75%,respectively,and the Yoden index was 0.751.Conclusion The expression of sFas and MMP-9 in serum of patients with dementia after cerebral infarction is up-regulated,and the expression of Angl-7 is down-regulated.The level of each index is correlated with the severity of the dis-ease.Combined detection has certain predictive value for poor prognosis,and can be used as an auxiliary index for clinical judgment and prognosis evaluation.

关 键 词：可溶性凋亡相关因子 基质金属蛋白酶-9 血管紧张素1-7 脑梗死后痴呆 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]