血清OX40L在缺血性脑卒中的诊断应用研究  

Research on the diagnostic application of serum OX40L in ischemic stroke

作　　者：查江杰 李梦真 国威 陈志会 韩鹏飞 程铭 ZHA Jiangjie;LI Mengzhen;GUO Wei;CHEN Zhihui;HAN Pengfei;CHENG Ming(The First Clinical Medical College,Mudanjiang Medical University,Heilongjiang,Mudanjiang 157000,China;Department of Life Science,Mudanjiang Medical University,Heilongjiang,Mudanjiang 157000,China;Department of Emergency,Hongqi Hospital Affiliated to Mudanjiang Medical University,Heilongjiang,Mudanjiang 157000,China;Department of Clinical Laboratory,Hongqi Hospital Affiliated to Mudanjiang Medical University,Heilongjiang,Mudanjiang 157000,China)

机构地区：[1]牡丹江医学院第一临床医学院,黑龙江牡丹江157000 [2]牡丹江医学院生命科学学院,黑龙江牡丹江157000 [3]牡丹江医学院附属红旗医院急诊科,黑龙江牡丹江157000 [4]牡丹江医学院附属红旗医院检验科,黑龙江牡丹江157000

出　　处：《中国医药科学》2024年第23期160-163,共4页China Medicine And Pharmacy

基　　金：黑龙江省省属高等学校基本科研业务费科研项目(2023-KYYWF-0924)。

摘　　要：目的通过检测缺血性脑卒中(IS)患者血液样本与健康体检人群血液样本中OX40配体(OX40L)水平,分析OX40L作为生物标志物对IS的诊断应用价值。方法选取2022年10月至2023年6月在牡丹江医学院附属红旗医院(本院)确诊的160例IS患者(IS组)和本院100例健康体检人员(对照组)为研究对象,根据美国国立卫生院卒中量表(NIHSS)评分、急性卒中0rg 10172治疗试验(TOAST)分型对IS患者进行分组。对IS患者不同分组中血清OX40L水平进行比较,评估OX40L对IS的诊断应用价值。结果IS组血清OX40L水平高于对照组,差异有统计学意义(P<0.05);随着脑卒中严重程度的加重,血清OX40L水平升高(P<0.05),且在TOAST分型中各组间血清OX40L水平比较,差异有统计学意义(P<0.05)。相关性分析结果显示,OX40L与脂蛋白a[Lp(a)]、同型半胱氨酸(Hcy)、NIHSS评分均呈正相关(r=0.583、0.427和0.685,P<0.05)。二元logistic回归多因素分析结果显示,OX40L是IS发生的独立危险因素[OR=1.013,95%CI(1.007~1.018),P<0.05]。受试者工作特征曲线显示,Lp(a)、Hcy、OX40L诊断IS的曲线下面积(AUC)分别为0.683、0.754、0.817,三者联合检测诊断IS的AUC为0.845。结论OX40L与IS发生有关,检测IS患者血清中OX40L表达水平有助于判断TOAST分型各亚型之间差异以及IS的病情严重程度,OX40L或可作为IS的辅助诊断指标。Objective To analyze the diagnostic application value of OX40L as a biomarker for ischemic stroke(IS)by detecting the level of OX40 ligand(OX40L)in blood samples from patients with IS and healthy individuals undergoing physical examination.Methods A total of 260 patients with IS diagnosed in Hongqi Hospital Affiliated to Mudanjiang Medical University(our hospital)(IS group)and 100 healthy medical checkups in our hospital(control group)from October 2022 to June 2023 were selected for the study,and the patients with IS were typed according to the National Institutes of Health Stroke scale(NIHSS)scores,and the trial of Org 10172 in acute stroke treatment(TOAST).Serum OX40L level was compared among different groups of IS patients to evaluate the diagnostic value of OX40L for IS.Results The level of serum OX40L in the IS group was higher than that in the control group,with a statistically significant difference(P<0.05).With the severity of stroke getting worse,the level of serum OX40L increased(P<0.05),and comparison of serum OX40L levels between groups in TOAST typing showed statistically significant differences(P<0.05).Correlation analysis showed that OX40L was positively correlated with lipoprotein a(Lp[a]),homocysteine(Hcy)and NIHSS score(r=0.583,0.427 and 0.685,P<0.05).The multivariate analysis of binary logistic regression showed that OX40L was an independent risk factor for the development of IS(OR=1.013,95%CI[1.007-1.018],P<0.05).The receiver operating characteristic curve showed that the AUC of Lp(a),Hcy and OX40L in diagnosing IS were 0.683,0.754 and 0.817 respectively,and the AUC of the combined detection and diagnosis of IS was 0.845.Conclusion OX40L is correlated to the occurrence of IS.Detecting the expression level of OX40L in the serum of IS patients is helpful to judge the difference between subtypes of TOAST typing and the severity of IS,and OX40L may be used as an auxiliary diagnostic index of IS.

关 键 词：OX40L 同型半胱氨酸 脂蛋白A 缺血性脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]