血清S100A8/A9水平对急性缺血性卒中患者rt-PA静脉溶栓后早期神经功能恶化有预测价值  

Serum S100A8/A9 level has predictive value for early neurological deterioration in patients with acute ischemic stroke after rt-PA intravenous thrombolysis

作　　者：石博 刘其率 孙佳佳 郇志刚 范甜甜 朱文燕 SHI Bo;LIU Qi-lv;SUN Jia-jia;XUN Zhi-gang;FAN Tian-tian;ZHU Wen-yan(Department of Neurology,Zibo First Hospital,Shandong Zibo,255000,China)

机构地区：[1]淄博市第一医院神经内科,山东淄博255000

出　　处：《内科急危重症杂志》2024年第6期532-535,共4页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨血清S100钙结合蛋白A8/A9复合物(S100A8/A9)水平与急性缺血性卒中(AIS)患者重组人组织型纤溶酶原激活物(rt-PA)静脉溶栓后早期神经功能恶化(END)的关系。方法:选取180例接受rt-PA静脉溶栓的AIS患者为研究对象,根据是否发生END分为END组(37例)和非END组(143例)。采用酶联免疫吸附法(ELISA)检测血清S100A8/A9水平,分析发生END的影响因素;采用受试者工作特征(ROC)曲线分析S100A8/A9对END发生的预测价值。结果:有心房颤动史、高血压史的AIS患者更易发生END。与非END组比较,END组发病至溶栓时间更长、美国国立卫生研究院卒中量表(NIHSS)评分及血清S100A8/A9水平更高(P均<0.05)。ROC曲线分析显示,血清S100A8/A9预测AIS患者rt-PA静脉溶栓后发生END的曲线下面积为0.791(0.692~0.891),最佳截断值为1.807 mg/mL时,敏感度为78.4%,特异性为79.0%;心房颤动史、高血压史、NIHSS评分、S100A8/A9是发生END的影响因素(P均<0.05)。结论:S100A8/A9可作为判断AIS静脉溶栓后是否发生END的辅助指标。Objective:To investigate the relationship between serum S100 calbindin A8/A9 complex(S100A8/A9)level and early neurological deterioration(END)in patients with acute ischemic stroke(AIS)after intravenous thrombolysis with recombinant human tissue plasminogen activator(rt-PA).Methods:A total of 180 AIS patients who received rt-PA intravenous thrombolysis were selected as the research objects and categorized into 37 in the END group and 143 in the non-END group.Serum S100A8/A9 levels were assayed using enzyme-linked immunosorbent assay(ELISA)and factors influencing the occurrence of END were analyzed.Receiver operating characteristic(ROC)curves were used to analyze the predictive value of S100A8/A9 for the occurrence of END.Results:Patients with AIS with a history of atrial fibrillation and hypertension were more likely to have END(P<0.05).The time from onset to thrombolysis was longer,and the score of National Institutes of Health Stroke Scale(NIHSS)and the serum S100A8/A9 level in the END group was significantly higher than in the non-END group(P<0.05).ROC curve analysis showed that the AUC of serum S100A8/A9 predicting END after rt-PA intravenous thrombolysis in AIS was 0.791(0.692-0.891),when the best diagnostic cut-off value was 1.807 mg/mL,the corresponding sensitivity was 78.4%and the specificity was 79.0%.The history of atrial fibrillation,history of hypertension,NIHSS score,and S100A8/A9 were the influencing factors for the occurrence of END(P<0.05).Conclusion:S100A8/A9 can be used as an auxiliary index to determine whether END occurs after intravenous thrombolysis in AIS patients.

关 键 词：缺血性卒中 S100钙结合蛋白A8/A9复合物 RT-PA静脉溶栓 神经功能恶化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]