血浆细胞周期依赖性激酶9水平与急性大动脉粥样硬化型脑梗死病情进展及预后的相关性研究  

Correlations of plasma cyclin-dependent kinase 9 levelwith disease progression and prognosis in patients withacute large artery atherosclerotic cerebral infarction

作　　者：田雪勤 王嘉浩 季林铃 赵格格 蒋婧 王英歌 TIAN Xueqin;WANG Jiahao;JI Linling;ZHAO Gege;JIANG Jing;WANG Yingge(Department of Neurology,the Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu,225001;School of Medicine of Yangzhou University,Yangzhou,Jiangsu,225009)

机构地区：[1]扬州大学附属医院神经内科,江苏扬州225001 [2]扬州大学医学院,江苏扬州225009

出　　处：《实用临床医药杂志》2025年第1期6-12,共7页Journal of Clinical Medicine in Practice

基　　金：扬州大学医学创新转化专项基金“临床转化研究项目”基金资助项目(AHYZUZHXM 202102);中华国际医学交流基金会“脑血管病青年创新基金”资助项目(Z-2016-20-2101-08)。

摘　　要：目的 探讨大动脉粥样硬化(LAA)型脑梗死患者病情进展及预后的影响因素,并分析血浆细胞周期依赖性激酶9(CDK9)水平在LAA型脑梗死诊治中的价值。方法 选择2022年3月1日—2023年11月20日在扬州大学附属医院神经内科住院的急性脑梗死患者为研究对象。根据诊断标准,选择急性LAA型脑梗死患者98例为LAA组,急性小动脉闭塞性脑梗死(SAO)患者33例为SAO组;同时,纳入健康体检中心的年龄、性别匹配的健康体检者40例为对照组。按照LAA型脑梗死患者病情是否进展分为进展型脑梗死(PCI)组(39例)及非进展型脑梗死(NPCI)组(59例)。98例LAA型脑梗死患者在3个月随访过程中失访6例,根据随访90 d时改良Rankin量表(mRS)评分将其分为预后良好(mRS评分≤2分,59例)组和预后不良(mRS评分>2分,33例)组。收集研究对象入院后第2天空腹血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血糖(GLU)、糖化血红蛋白(HbA1c)、同型半胱氨酸(Hcy)]。脑梗死患者神经功能缺损程度采用美国国立卫生研究院卒中量表(NIHSS)评分进行评估。采用酶联免疫吸附测定法(ELISA)测定不同分组人群血浆CDK9水平;探讨急性LAA型脑梗死患者病情进展的影响因素;绘制受试者工作特征曲线评价CDK9对急性LAA的预测价值。结果 与对照组比较,LAA组HDL-C水平更低,CDK9水平更高,差异有统计学意义(P<0.05)。LAA组较SAO组糖尿病病史占比更高,梗死体积更大,入院时NIHSS评分更高,CDK9水平更高,差异有统计学意义(P<0.05)。二元Logistic回归分析结果显示,糖尿病病史以及血浆CDK9水平是LAA型脑梗死的影响因素。NPCI组与PCI组糖尿病病史占比、HbA1c、随机GLU和CDK9水平比较,差异有统计学意义(P<0.05)。有糖尿病病史以及血浆CDK9水平是急性LAA型脑梗死患者病情进展的影响因素。CDK9预测急性LAA型脑梗死的受试者工�Objective To investigate the influencing factors of disease progression and prognosis in patients with large artery atherosclerotic(LAA)cerebral infarction and analyze the value of plasma cyclin-dependent kinase 9(CDK9)level in the diagnosis and treatment of LAA cerebral infarction.Methods Patients with acute cerebral infarction admitted to the Department of Neurology of the Affiliated Hospital of Yangzhou University between March 1,2022,and November 20,2023,were selected.According to the diagnostic criteria,98 patients with acute LAA(LAA group)and 33 patients with acute small artery occlusion(SAO)cerebral infarction(SAO group)were selected.Additionally,40 healthy individuals matched for age and gender from the Health Examination Center were includedas control group. Based on whether the condition of LAA cerebral infarction patients progressing, they were divided into progressive cerebral infarction (PCI) group (39 patients) and the non-progressive cerebral infarction (NPCI) group (59 patients). During the 3-month follow-up period, 6 patients from the 98 LAA cerebral infarction patients were lost. According to the modified Rankin Scale (mRS) score at 90 days of follow-up, patients were divided into good prognosis group (mRS score ≤ 2, 59 patients) and poor prognosis group (mRS score >2, 33 patients). Fasting lipid indices [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), glucose (GLU), glycated hemoglobin (HbA1c), and homocysteine (Hcy)] were collected on the second day after admission. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of neurological impairment in cerebral infarction patients. Enzyme-linked immunosorbent assay (ELISA) was used to measure plasma CDK9 levels in different groups;factors influencing disease progression in patients with acute LAA cerebral infarction were explored;and receiver operating characteristic curves were plotted to evaluate the predictive value of CDK9 in

关 键 词：急性大动脉粥样硬化型脑梗死 细胞周期依赖性激酶9 美国国立卫生研究院卒中量表 进展性脑卒中 预后 

分 类 号：R446.11[医药卫生—诊断学] R459.7[医药卫生—临床医学] R743.3