血清血管生成素样蛋白4、过氧化物酶体增殖物激活受体γ表达水平与急性缺血性脑卒中预后的关系  

The relationship between the expression levels of serum Angptl4 and PPARγand the prognosis of patients with acute ischemic stroke

作　　者：刘丽鸽 闫秋月[1] 艾婧怡 焦如东 李猛[1] LIU Lige;YAN Qiuyue;AI Jingyi;JIAO Rudong;LI Meng(Department of Cerebrovascular Disease 4,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China;Department of Movement Disorders and Parkinson,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China;Department of Emergency Medicine,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市中心医院脑血管病四科,河北沧州061000 [2]沧州市中心医院帕金森、运动障碍科,河北沧州061000 [3]沧州市中心医院急诊医学部,河北沧州061000

出　　处：《安徽医药》2025年第2期324-328,共5页Anhui Medical and Pharmaceutical Journal

基　　金：沧州市科技计划自筹经费项目(213106036)。

摘　　要：目的探究血清血管生成素样蛋白4(Angptl4)、过氧化物酶体增殖物激活受体γ(PPARγ)表达水平与急性缺血性脑卒中预后的关系。方法选取2020年2月至2022年6月沧州市中心医院收治的急性缺血性脑卒中病人100例作为观察组,依据美国国立卫生研究院卒中量表(NIHSS)评分评估病情严重程度,分为轻症组(n=33,NIHSS评分<6分)、中症组(n=39,6分≤NIHSS评分<14分)、重症组(n=28,NIHSS评分≥14分);根据治疗90 d后改良Rankin量表(mRs)评分评估预后,分为预后良好组(n=68,0~2分)、预后不良组(n=32,≥3分);另选取同期健康志愿者100例作为对照组。酶联免疫吸附试验(ELISA)检测血清Angptl4、PPARγ表达水平,并进行组间比较;多因素logistic回归分析急性缺血性脑卒中病人预后的影响因素;受试者操作特征曲线(ROC曲线)分析血清Angptl4、PPARγ对预后的评估价值。结果观察组血清Angptl4[(14.16±3.28)μg/L比(11.52±2.36)μg/L]、PPARγ[(38.54±9.63)ng/L比(26.68±7.48)ng/L]表达水平高于对照组(P<0.05);重症组血清Angptl4、PPARγ表达水平高于轻症组和中症组,且中症组高于轻症组(P<0.05);预后不良组年龄、Angptl4、PPARγ、高血压比例、糖尿病比例、入院时NIHSS评分均明显高于预后良好组(P<0.05);血清Angptl4、PPARγ、NIHSS评分为急性缺血性脑卒中病人预后的影响因素(P<0.05);血清Angptl4、PPARγ二者联合评估急性缺血性脑卒中病人预后的曲线下面积(AUC)为0.98。结论血清Angptl4、PPARγ表达水平较高的急性缺血性脑卒中病人病情较严重,预后较差,血清Angptl4、PPARγ为急性缺血性脑卒中病人预后影响因素,能较好地评估病人预后情况。Objective To explore the relationship between the expression levels of serum angiopoietin like protein 4(Angptl4),per⁃oxisome proliferator activated receptorγ(PPARγ)and the prognosis of patients with acute ischemic stroke.Methods A total of 100 patients with acute ischemic stroke admitted to Cangzhou Central Hospital from February 2020 to June 2022 were collected as the study group,and according to the severity of the condition evaluated by the National Institutes of Health Stroke Scale(NIHSS),the pa⁃tients were assigned into mild group(n=33,NIHSS score<6 points),moderate group(n=39,6 points≤NIHSS score<14 points),and se⁃vere group(n=28,NIHSS score≥14 points).According to the prognostic condition evaluated by modified Rankin scale(mRs)90 days after treatment,the patients were grouped into a good prognosis group(n=68,0-2 points)and a poor prognosis group(n=32,≥3 points);another 100 healthy volunteers from the same period were collected as the control group.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the expression levels of Angptl4 and PPARγin serum,which were compared between groups;multivariate logistic regression was applied to analyze the influencing factors for the prognosis of patients with acute ischemic stroke;receiver operating characteristic(ROC)curve was applied to analyze the prognostic evaluation value of serum Angptl4 and PPARγ.Results The expres⁃sion levels of Angptl4[(14.16±3.28)μg/L vs.(11.52±2.36)μg/L]and PPARγ[(38.54±9.63)ng/L vs.(26.68±7.48)ng/L]in the study group were higher than those in the control group(P<0.05).The expression levels of Angptl4 and PPARγin the serum of the severe group were higher than those of the mild and moderate groups,with the moderate group higher than the mild group(P<0.05).Age,Ang⁃ptl4,PPARγ,proportion of hypertension,proportion of diabetes,NIHSS score at admission in the poor prognosis group were obviously higher than those in the good prognosis group(P<0.05).Serum Angptl4,PPARγ,and NIHSS scores were influencing factor

关 键 词：卒中 脑梗死 血管生成素样蛋白4 过氧化物酶体增殖物激活受体Γ 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]