血清CXCL12、UCP2对老年脑梗死患者预后的预测价值  

Predictive value of serum CXCL12 and UCP2 on the prognosis of elderly patients with cerebral infarction

作　　者：马红梅 赵春水 郝彦超 陈辉 蒋鹏旭 白一蕾 马焕 朱洁 胡玉洁 MA Hong-mei;ZHAO Chun-shui;HAO Yan-chao;CHEN Hui;JIANG Peng-xu;BAI Yi-lei;MA Huan;ZHU Jie;HU Yu-jie(First Department of Neurology,Kaifeng Central Hospital,Kaifeng 475000,Henan,CHINA)

机构地区：[1]开封市中心医院神经内科一病区,河南开封475000

出　　处：《海南医学》2025年第6期812-816,共5页Hainan Medical Journal

基　　金：2022年度河南省开封市科技发展计划项目(编号:2203083)。

摘　　要：目的探讨血清趋化因子CXC配体12(CXCL12)、解偶联蛋白2(UCP2)对老年脑梗死患者预后的预测价值。方法前瞻性选取2020年5月至2022年5月于开封市中心医院接受静脉溶栓治疗的246例老年脑梗死患者作为研究组,同期121例健康老年人群作为对照组。比较两组受检者的血清CXCL12、UCP2水平以及不同预后老年脑梗死患者的临床资料和血清CXCL12、UCP2水平;采用多因素Logistic回归分析老年脑梗死患者预后不良的影响因素;采用受试者工作特征(ROC)曲线分析血清CXCL12、UCP2水平检测对老年脑梗死患者预后不良的预测价值;比较研究组患者治疗前后的血清CXCL12、UCP2水平。结果研究组患者的血清CXCL12水平为(18.05±1.87)mg/L,明显高于对照组的(14.53±1.65)mg/L,血清UCP2水平为(212.42±22.31)ng/mL,明显低于对照组的(440.18±48.46)ng/mL,差异均有统计学意义(P<0.05);预后不良组患者合并冠心病、高血压、糖尿病的占比以及美国国立卫生研究院卒中量表(NIHSS)评分和血清CXCL12水平明显高于预后良好组,而血清UCP2水平明显低于预后良好组,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,血清CXCL12是老年脑梗死患者预后不良的危险因素(P<0.05),而UCP2是保护因素(P<0.05);ROC曲线分析结果显示,CXCL12、UCP2联合预测老年脑梗死预后不良的曲线下面积(AUC)(95%CI)为0.891(0.845~0.927),均高于CXCL12、UCP2单独预测的0.844(95%CI:0.792~0.887)、0.839(95%CI:0.787~0.882),联合预测的敏感度为70.19%,特异度为97.18%,两者联合均高于血清CXCL12、UCP2各自单独预测(P<0.05);研究组患者治疗后的血清CXCL12水平为(14.89±1.57)mg/L,明显低于治疗前的(18.05±1.87)mg/L,UCP2水平为(436.57±46.52)ng/mL,明显高于治疗前的(212.42±22.31)ng/mL,差异均有统计学意义(P<0.05)。结论老年脑梗死患者血清CXCL12水平升高,血清UCP2水平降低,血清CXCL12、UCP2联合预测老年脑梗死患者预后�Objective To investigate the predictive value of serum chemokine CXC ligand 12(CXCL12)and uncoupling protein 2(UCP2)on the prognosis of elderly patients with cerebral infarction.Methods A prospective study included 246 elderly patients with cerebral infarction who underwent intravenous thrombolysis at Kaifeng Central Hospital from May 2020 to May 2022(study group)and 121 healthy elderly individuals(control group).Serum CXCL12 and UCP2 levels were compared between the two groups,as well as between patients with favorable and unfavorable prognoses.Multivariate logistic regression was used to identify risk factors for poor prognosis.Receiver operating characteristic(ROC)curves were employed to evaluate the predictive value of CXCL12 and UCP2 levels.Changes in serum CXCL12 and UCP2 levels before and after treatment were also analyzed.Results The serum CXCL12 level of the patients in the study group was(18.05±1.87)mg/L,which was significantly higher than(14.53±1.65)mg/L of the control group,and the serum UCP2 level of the patients in the study group was(212.42±22.31)ng/mL,which was significantly lower than(440.18±48.46)ng/mL of the control group,with statistically significant differences(P<0.05).Patients with poor prognosis had higher proportions of comorbidities(coronary heart disease,hypertension,diabetes),higher National Institutes of Health Stroke Scale(NIHSS)scores,and higher CXCL12 levels,but lower UCP2 levels than those with favorable prognosis(P<0.05).Multifactorial logistic regression analysis showed that serum CXCL12 was a risk factor for poor prognosis in elderly patients with cerebral infarction(P<0.05),whereas UCP2 was a protective factor(P<0.05).ROC analysis showed that the combination of CXCL12 and UCP2 for predicting the risk of poor prognosis had an AUC of 0.891(95%CI:0.845-0.927),outperforming individual markers(CXCL12:AUC=0.844,95%CI:0.792-0.887;UCP2:AUC=0.839,95%CI:0.787-0.882).The combined sensitivity and specificity were 70.19%and 97.18%,respectively,significantly better than those of individ

关 键 词：老年脑梗死 趋化因子CXC配体12 解偶联蛋白2 预后 预测价值 

分 类 号：R743.33[医药卫生—神经病学与精神病学]