血清神经元正五聚蛋白2、肝素结合表皮生长因子样生长因子对急性缺血性脑卒中患者临床结局的预测价值分析  

Analysis of the predictive value of serum neuronal pentraxin 2 and heparin-binding epidermal growth factor-like growth factor on clinical outcomes in patients with acute ischemic stroke

作　　者：张琳 吕文艳 刘佳乐 陈明鑫 李娜 ZHANG Lin;LV Wen-yan;LIU Jia-le;CHEN Ming-xin;LI Na(Baoji Hospital Affiliated to Xi'an Medical College,Baoji 721006,China;Xianyang Maternal and Child Health Hospital,Xianyang 712000,China)

机构地区：[1]西安医学院附属宝鸡医院,陕西宝鸡721006 [2]陕西省咸阳市妇幼保健院,陕西咸阳712000

出　　处：《实用医院临床杂志》2025年第2期100-104,共5页Practical Journal of Clinical Medicine

基　　金：陕西省自然科学基础研究计划项目(编号:2021JM-259)。

摘　　要：目的探讨血清神经元正五聚蛋白2(NPTX2)、肝素结合表皮生长因子样生长因子(HB-EGF)对急性缺血性脑卒中(AIS)患者临床结局的预测价值。方法选取2021年9月至2023年8月我院收治的103例AIS患者,根据病情分为轻度组31例、中度组53例、重度组19例。连续随访6个月,根据临床结局不同分为结局良好组78例、结局不良组25例。比较不同病情、临床结局AIS患者血清NPTX2、HB-EGF水平;采用受试者工作特性(ROC)曲线评估血清NPTX2、HB-EGF对AIS患者临床结局的预测价值;Logistic逐步回归分析探讨AIS患者临床结局的影响因素。结果血清NPTX2水平轻度组>中度组>重度组,血清HB-EGF水平轻度组<中度组<重度组(P<0.05);结局良好组血清NPTX2水平高于结局不良组,HB-EGF水平低于结局不良组(P<0.05);血清NPTX2、HB-EGF以及两项指标联合预测AIS患者临床结局的曲线下面积(95%CI)分别为0.769(0.718~0.820)、0.861(0.810~0.912)、0.904(0.853~0.955),截点值分别为25.30 ng/ml、219.27 ng/L,特异度分别为56.93%、67.03%、86.74%,灵敏度分别为91.09%、91.09%、84.22%。Logistic逐步回归分析结果显示,大面积梗死、入院时NIHSS评分高、NPTX2低表达、HB-EGF高表达是AIS患者不良临床结局的独立危险因素(P<0.05)。结论血清NPTX2水平降低、HB-EGF水平升高与AIS患者病情、不良临床结局有关,两项指标可作为预测AIS患者临床结局的潜在生物标记物。Objective To investigate the predictive value of serum neuronal pentraxin 2(NPTX2)and heparin-binding epidermal growth factor-like growth factor(HB-EGF)on the clinical outcome of patients with acute ischemic stroke(AIS).Methods One hundred and three AIS patients admitted to our hospitals from September 2021 to August 2023 were selected.According to the conditions of the disease,they were divided into a mild group(n=31),a moderate group(n=53)and a severe group(n=19).After continuous follow-up for 6 months,the patients were divided into a good outcome group(n=78)and a poor outcome group(n=25)according to the different clinical outcomes.The serum levels of NPTX2 and HB-EGF in AIS patients with different conditions and clinical outcomes were compared.The receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of serum NPTX2 and HB-EGF for the clinical outcome of AIS patients.The binary logistic stepwise regression analysis was used to explore the influencing factors of the clinical outcome of the AIS patients.Results The serum NPTX2 level in the mild group>the moderate group>the severe group,and the serum HB-EGF level in the mild grouP<the moderate grouP<the severe group(P<0.05).The serum NPTX2 level in the good outcome group was higher than that in the poor outcome group,and the HB-EGF level was lower than that in the poor outcome group(P<0.05).The area under the curve(AUC)(95%CI)of serum NPTX2,HB-EGF and the combination of the two indexes in predicting the clinical outcome of AIS patients were 0.769(0.718~0.820),0.861(0.810~0.912)and 0.904(0.853~0.955),respectively.The cut-off values were 25.30 ng/ml and 219.27 ng/L.The specificities were 56.93%,67.03%and 86.74%,The sensitivities were 91.09%,91.09%and 84.22%.Logistic stepwise regression analysis showed that largescale infarction,high NIHSS score at admission,low expression of NPTX2,and high expression of HB-EGF were independent risk factors for adverse clinical outcomes in patients with AIS(P<0.05).Conclusions The decreased se

关 键 词：急性缺血性脑卒中 神经元正五聚蛋白2 肝素结合表皮生长因子样生长因子 病情 临床结局 

分 类 号：R743.3[医药卫生—神经病学与精神病学]