血清CXCL12、CCCK-18、MMP-9联合检测对急性出血性脑卒中患者近期预后不良的预测价值  

Predictive value of combined detection of serum CXCL12,CCCK-18 and MMP-9 for short-term poor prognosis in patients with acute hemorrhagic stroke

作　　者：夏文静[1] 陈媛媛 李义沙 王倩[1] XIA Wenjing;CHEN Yuanyuan;LI Yisha;WANG Qian(First Department of Neurology Medicine,Handan First Hospital,Handan,Hebei 056000,China)

机构地区：[1]邯郸市第一医院神内一科,河北邯郸056000

出　　处：《国际检验医学杂志》2025年第3期297-302,307,共7页International Journal of Laboratory Medicine

基　　金：邯郸市科学技术研究与发展计划项目(1623208039ZC)。

摘　　要：目的 探讨血清CXC趋化因子配体12(CXCL12)、细胞角蛋白18裂解片段(CCCK-18)、基质金属蛋白酶-9(MMP-9)联合检测对急性出血性脑卒中患者近期预后不良的预测价值。方法 选取2021年10月至2023年3月该院收治的138例急性出血性脑卒中患者为研究对象。患者入院后治疗前检测血清CXCL12、CCCK-18、MMP-9水平。患者治疗后随访6个月,根据改良Rankin评分评估患者预后情况分为预后良好组与预后不良组。对比两组患者临床资料及血清CXCL12、CCCK-18、MMP-9水平,分析影响急性出血性脑卒中患者近期预后不良的因素,绘制受试者工作特征(ROC)曲线评价血清CXCL12、CCCK-18、MMP-9单项及联合检测对急性出血性脑卒中患者近期预后不良的预测价值。结果 138例患者中预后不良组52例,预后良好组86例,预后不良率为37.68%。预后不良组血清CXCL12、CCCK-18、MMP-9水平及年龄、入院时出血量、入院时美国国立卫生研究院卒中量表(NIHSS)评分、入院时收缩压、入院时舒张压均高于预后良好组,入院时格拉斯哥昏迷量表(GCS)评分低于预后良好组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,血清CXCL12高水平、CCCK-18高水平、MMP-9高水平、高龄及入院时出血量大、NIHSS评分高、收缩压高均是急性出血性脑卒中近期预后不良的危险因素(P<0.05),入院时GCS评分高是保护因素(P<0.05)。ROC曲线分析显示,血清CXCL12、CCCK-18、MMP-9 3项联合预测曲线下面积高于各指标单独及两两联合预测(P<0.05)。结论 血清CXCL12、CCCK-18、MMP-9联合检测对急性出血性脑卒中患者近期预后不良具有较好的预测价值。Objective To explore the predictive value of combined detection of serum CXC chemokine ligand 12(CXCL12),caspase-cleaved cytokeratin 18(CCCK-18)and matrix metalloproteinase-9(MMP-9)for short-term poor prognosis in patients with acute hemorrhagic stroke.Methods A total of 138 patients with acute hemorrhagic stroke admitted to a hospital from October 2021 to March 2023 were selected as the study objects.Serum CXCL12,CCCK-18 and MMP-9 levels were detected after admission and before treatment.Patients were followed up for 6 months after treatment and were divided into good prognosis group and poor prognosis group according to the modified Rankin scale score.Clinical data and serum CXCL12,CCCK-18 and MMP-9 levels of the two groups were compared to analyze the factors affecting the short-term poor prognosis of patients with acute hemorrhagic stroke.Receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of single and combined detection of serum CXCL12,CCCK-18 and MMP-9 in patients with acute hemorrhagic stroke.Results Among 138 patients,there were 52 cases in the poor prognosis group and 86 cases in the good prognosis group,and the poor prognosis rate was 37.68%.Serum CXCL12,CCCK-18 and MMP-9 levels,age,blood loss at admission,National Institutes of Health Stroke Scale(NIHSS)score at admission,systolic blood pressure and diastolic blood pressure at admission in the poor prognosis group were higher than those in the good prognosis group.The score of Glasgow Coma Scale(GCS)at admission was lower than that of good prognosis group,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that high level of serum CXCL12,high level of CCCK-18,high level of MMP-9,older age,large amount of blood loss upon admission,high NIHSS score and high systolic blood pressure were all risk factors for short-term poor prognosis of acute hemorrhagic stroke(P<0.05).High GCS score on admission was a protective factor(P<0.05).ROC curve analysis showed that the area

关 键 词：CXC趋化因子配体12 细胞角蛋白18裂解片段 基质金属蛋白酶-9 急性出血性脑卒中 

分 类 号：R743.34[医药卫生—神经病学与精神病学]