急性脑梗死并认知功能障碍的血清生化指标预测研究  

Study on Prediction of Serum Biochemical Indicators in Acute Cerebral Infarction with Cognitive Dysfunction

作　　者：王燕 汪晶晶 王红丽 孔羽[2] WangYan;Wang Jingjing;Wang Hongli(Department of Neurology,The First People’s Hospital of Shangqiu,Shangqiu,Henan,476000,China)

机构地区：[1]商丘市第一人民医院神经内科,河南商丘476000 [2]商丘市第一人民医院认知与运动障碍科,河南商丘476000

出　　处：《黑龙江医学》2025年第6期659-662,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨血清血栓调节蛋白(TM)、氧化低密度脂蛋白(OxLDL)、中枢神经特异性蛋白(S100β)对急性脑梗死(ACI)并认知功能障碍(CD)的预测价值。方法:选取2021年1月—2023年1月商丘市第一人民医院收治的216例ACI患者作为疾病组,另选同时到院体检的216例健康志愿者作为对照组,检测两组对象血清TM、OxLDL、S100β水平并比较。根据疾病组是否并发CD将其分为CD组和非CD组,比较两组患者血清TM、OxLDL、S100β水平。分析ACI并CD的影响因素及血清TM、OxLDL、S100β对ACI并CD的预测价值。结果:疾病组患者血清TM、OxLDL、S100β水平均高于对照组,差异均有统计学意义(t=12.853、17.051、31.354,P<0.05);ACI患者CD发生率为37.96%;logistic回归分析结果显示,血清TM、OxLDL、S100β水平较高均是ACI并CD的危险因素(OR=1.978、1.326、2.875,P<0.05);ROC曲线结果显示,血清TM、OxLDL、S100β联合预测ACI并CD的灵敏度和曲线下面积分别为93.90%、83.58%,均高于各指标单独预测,其特异度与各指标单独预测基本一致。结论:ACI患者血清TM、OxLDL、S100β水平均升高,且对ACI并CD具有一定的预测价值,但三者联合预测价值更高。Objective:To explore the predictive value of serum thrombomodulin(TM),oxidized low density lipoprotein(OxLDL)and central nervous system specific protein(S100β)in acute cerebral infarction(ACI)with cognitive dysfunction(CD).Methods:216 patients with ACI were selected as the disease group,while 216 healthy volunteers were selected as the control group.The levels of serum TM,OxLDL,S100βbetween the two groups were detected and compared.The disease group was divided into CD group and non CD group based on whether they had concurrent CD,and the levels of serum TM,OxLDL and S100βwere compared between the two groups.The influencing factors of ACI with CD and the predictive value of serum TM,OxLDL,S100βfor ACI with CD were analyzed.Results:The levels of serum TM,OxLDL and S100βin the disease group were higher than those in the control group(t=12.853,17.051,31.354;P<0.05).The incidence of ACI with CD was 37.96%.Logistic regression analysis showed that high admission NIHSS score and serum levels of TM,OxLDL and S100βwere all risk factors for ACI with CD(OR=1.978,1.326,2.875;P<0.05).The ROC curve analysis showed that the sensitivity and area under curve of the combination of serum TM,OxLDL and S100βin predicting ACI with CD were 93.90%and 83.58%,respectively,and their specificity was basically consistent with the individual predictions of each indicator.Conclusion:The levels of serum TM,OxLDL,S100βin patients with ACI are elevated,and all of which have certain predictive value for ACI with CD,but the combined predictive value of the three is higher.

关 键 词：血栓调节蛋白 氧化低密度脂蛋白 中枢神经特异性蛋白 急性脑梗死 认知功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]