ABCD2评分联合血清YKL-40、sFGL2对短暂性脑缺血发作后发生脑梗死的预测价值  

Clinical value of ABCD2 score combined with serum YKL-40 and sFGL2 in predicting the occurrence of cerebral infarction after transient ischemic attack

作　　者：朱召蕾 霍瑞民[1] 赵俊杰 ZHU Zhaolei;HUO Ruimin;ZHAO Junjie(Department of Second Neurology,Handan First Hospital,Handan,Hebei 056000,China)

机构地区：[1]邯郸市第一医院神内二科,河北邯郸056000

出　　处：《安徽医药》2025年第5期927-931,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河北省医学科学研究计划项目(20220485)。

摘　　要：目的探索年龄、血压、临床特征、症状持续时间、糖尿病评分(ABCD2)评分联合血清甲壳质酶蛋白-40(YKL-40)、可溶性纤维蛋白原2(sFGL2)预测短暂性脑缺血发作(TIA)后发生脑梗死(CI)的临床价值。方法选取2022年4月至2023年4月邯郸市第一医院收治的253例TIA病人作为研究对象,其中脑梗死组98例,非脑梗死组155例。收集病人的临床资料,对两组病人血清中三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、空腹血糖(FBG)、血尿酸(BUA)及YKL-40、sFGL2水平进行检测,并进行ABCD2评分;多因素logistic回归分析影响因素;受试者操作特征曲线(ROC曲线)分析预测价值。结果脑梗死组中高脂血症病人比例,发作次数、发作至就诊时间以及持续时间均高于非脑梗死组(P<0.05),脑梗死组病人血清TG、sFGL2水平分别为(1.78±0.14)mmol/L、(20.53±1.77)μg/L低于非脑梗死病人(2.73±0.26)mmol/L、(23.35±2.38)μg/L,血清BUA、YKL-40水平和ABCD2评分分别为(328.43±25.36)μmol/L、(94.56±9.47)μg/L、(3.03±0.52)分高于非脑梗死病人(285.47±26.41)μmol/L、(83.26±7.88)μg/L、(2.46±0.31)分,差异有统计学意义(P<0.05);多因素logistic回归分析显示发作次数、发作至就诊时间、持续时间、血清YKL-40和sFGL2水平、ABCD2评分是TIA后发生脑梗死的影响因素(P<0.05);曲线下面积(AUC)显示,ABCD2评分联合YKL-40、sFGL2预测TIA后脑梗死的AUC为0.93,95%CI:(0.89,0.96),联合诊断的AUC显著大于YKL-40单独预测的AUC(Z=5.73,P<0.001),sFGL2单独预测的AUC(Z=4.73,P<0.001),ABCD2评分单独预测的AUC(Z=5.58,P<0.001)。结论TIA后发生脑梗死病人血清YKL-40水平升高,血清sFGL2水平降低,ABCD2评分联合血清YKL-40和sFGL2预测TIA后发生脑梗死风险的价值更高。Objective To explore the clinical value of ABCD2 score combined with serum chitinase protein-40(YKL-40)and soluble fibrinogen 2(sFGL2)in predicting cerebral infarction(CI)after transient ischemic attack(TIA).Methods A total of 253 TIA patients admitted in Handan First Hospital from April 2022 to April 2023 were selected for the study,including 98 cases in the cerebral infarction group and 155 cases in the non-cerebral infarction group.The clinical data of the patients were collected,and the serum levels of TG,LDL-C,HDL-C,TC,FBG,blood uric acid(BUA),and YKL-40 and sFGL2 were tested in both groups,and the ABCD2 score was performed.Multifactor logistic regression was used to analyze impact factors.ROC curve analysis was used to analyze the predictive value.Results The proportion of patients with hyperlipidemia,the number of episodes,the time between episodes and clinic visits,and the duration were higher in the cerebral infarction group than in the non-cerebral infarction group(P<0.05).The serum TG and sFGL2 levels of patients in the cerebral infarction group were(1.78±0.14)mmol/L,(20.53±1.77)μg/L lower than those of patients with non-cerebral infarction(2.73±0.26)mmol/L,(23.35±2.38)μg/L,and the serum BUA and YKL-40 levels and ABCD2 score were(328.43±25.36)μmol/L,(94.56±9.47)μg/L,and(3.03±0.52)scores were higher than those of non-cerebral infarction patients(285.47±26.41)μmol/L,(83.26±7.88)μg/L,and(2.46±0.31)scores,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that the number of attacks,the time from attack to treatment,the duration,serum YKL-40 and sFGL2 levels,and ABCD2 score were the influencing factors of CI after TIA(P<0.05);the area under the ROC curve(AUC)showed that the AUC of CI predicted by the combination of ABCD2 score and YKL-40,sFGL2 after TIA was 0.93,95%CI:(0.89,0.96),the AUC of the combination diagnosis was obviously higher than that predicted by YKL-40 alone(Z=5.73,P<0.001),the AUC predicted by sFGL2 alone(Z=4.73,P<0.001),a

关 键 词：脑梗死 ABCD2评分 甲壳质酶蛋白-40 可溶性纤维蛋白原2 脑缺血发作 短暂性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]