急性分水岭脑梗死患者血清LRG1,DPP4水平表达对临床诊断及预后评估研究  

Clinical Diagnosis and Prognosis Evaluation of Serum LRG1 and DPP4 Levels in Patients with Acute Watershed Cerebral Infarction

作　　者：贾磊华 吕志坤[1] 魏萌萌 李国珍[1] JIA Leihua;LU Zhikun;WEI Mengmeng;LI Guozhen(Department of Neurology,Baoding Second Central Hospital,Hebei Zhuozhou 072750,China)

机构地区：[1]保定市第二中心医院神经内科,河北涿州072750

出　　处：《现代检验医学杂志》2025年第2期98-103,共6页Journal of Modern Laboratory Medicine

摘　　要：目的探究血清亮氨酸丰富α-2-糖蛋白1(LRG1)、二肽基肽酶(DPP4)水平对急性分水岭脑梗死(ACWI)患者的诊断及预后评估的价值。方法以2022年1月~2023年12月在保定市第二中心医院诊治的150例ACWI患者为研究对象(ACWI组),同时另选120例体检的志愿者为对照组,根据ACWI患者预后情况分为预后良好组(n=98)和预后不良组(n=52)。ELISA检测血清LRG1,DPP4,癌胚抗原(CEA)水平;生化分析仪检测血清清蛋白(ALB)、腺苷脱氨酶(ADA)、肌酐(Cre)水平。多因素Logistic回归分析ACWI患者预后不良的影响因素;Spearman相关性分析ACWI组血清LRG1,DPP4水平与美国国立卫生研究院卒中量表(NIHSS)及改良Rankin量表(mRS)评分的相关性;ROC曲线分析血清LRG1,DPP4水平对ACWI发生及患者预后情况的诊断价值,Z检验比较AUC的差异。结果ACWI患者血清LRG1(56.03±16.11pg/ml),DPP4(9.90±3.25ng/L)水平高于正常对照组(41.78±12.54pg/ml,7.34±2.32ng/L),差异具有统计学意义(t=7.951,7.272,均P<0.001)。预后不良组患者NIHSS评分、mRS评分、大面积梗死比例以及LRG1,DPP4水平均高于预后良好组患者(t/χ^(2)=3.258~17.208),ALB水平低于预后良好组患者(t=3.143),差异具有统计学意义(均P<0.05)。多因素Logistic回归分析,大面积梗死以及NIHSS评分、mRS评分、LRG1,DPP4水平增加是ACWI患者预后不良的独立危险因素(Wald χ^(2)=4.358~6.000,均P<0.05),而ALB升高是ACWI患者预后不良的独立保护因素(Wald χ^(2)=4.535,P<0.05)。Spearman相关性分析显示ACWI患者血清LRG1与DPP4水平呈正相关(r=0.446,P=0.000);ROC曲线分析血清LRG1,DPP4诊断发生ACWI的AUC(95%CI)分别为0.788(0.734~0.835),0.790(0.736~0.837),联合诊断的AUC(95%CI)为0.922(0.883~0.951),优于各自单独诊断(Z=5.798,5.612,均P<0.05);血清LRG1,DPP4诊断ACWI患者预后不良的AUC(95%CI)分别为0.796(0.722~0.857),0.800(0.727~0.861),联合诊断的AUC(95%CI)为0.924(0.869~0.961),优于各自单独诊断(Z=2.891,4.222,均P<0.05)。结Objective To investigate the diagnostic and prognostic value of serum leucine-rich alpha-2-glycoprotein 1(LRG1)and dipeptidyl peptidase 4(DPP4)levels in patients with acute cerebral watershed infarction(ACWI).Methods Selected 150 ACWI patients treated in the Baoding Second Central Hospital from January 2022 to December 2023 as the study subjects(ACWI group),and another 120 volunteers who underwent physical examinations were regarded as the control group.According to the prognosis of ACWI patients,they were separated into a good prognosis group(n=98)and a poor prognosis group(n=52).ELISA was used to detect serum LRG1,DPP4 and carcinoembryonic amtigen(CEA)levels,a biochemical analyzer was used to detect levels of albumin(ALB),adenosine deaminase(ADA),creatinine(Cre).Multivariate logistic regression was applied to analyze the influencing factors of poor prognosis in ACWI patients.Spearman correlation analysis of LRG1 and DPP4 levels with NIHSS and mRS scores in the ACWI group.The ROC curve was applied to analyze the diagnostic value of LRG1 and DPP4 levels for the occurrence of ACWI and prognosis,and Z-test was used to compare the differences in AUC.Results The serum LRG1(56.03±16.11pg/ml)and DPP4(9.90±3.25ng/L)levels in ACWI patients were higher than those in the control group(41.78±12.54pg/ml,7.34±2.32ng/L),the differences were statistically significant(t=7.951,7.272,all P<0.001).ACWI patients with poor prognosis had higher National Institute of Health Stroke Scale NIHSS scores,mRS scores,larger infarct proportion,LRG1 and DPP4 levels than those with good prognosis(t/χ^(2)=3.258~17.208),but had lower ALB levels than those with good prognosis(t=3.143),the differences were statistically significant(all P<0.001).Multivariate logistic regression analysis showed that large area infarction,increased NIHSS score,mRS score,LRG1 and DPP4 levels were independent risk factors for poor prognosis in ACWI patients(Wald χ^(2)=4.358~6.000,all P<0.05),while elevated ALB was an independent protective factor for poor prognosis

关 键 词：急性分水岭脑梗死 氨酸丰富α-2-糖蛋白1 二肽基肽酶 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R392.11[医药卫生—临床医学]