血清β2微球蛋白与急性缺血性卒中患者卒中严重程度和转归的相关性  

Associations of serumβ2-microglobulin with the severity and outcome in patients with acute ischemic stroke

作　　者：刘婧 祁智 王施 马海玲 秦敬翠 郝宁 Liu Jing;Qi Zhi;Wang Shi;Ma Hailing;Qin Jingcui;Hao Ning(Department of Neurology,the Affiliated Municipal Hospital of Xuzhou Medical University,Xuzhou 221000,China;Department of Neurology,the Third Hospital Affiliated to Naval Medical University,Shanghai 201805,China;Department of Neurology,Xuzhou Central Hospital,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属市立医院神经内科,徐州221000 [2]海军军医大学第三附属医院神经内科,上海201805 [3]徐州市中心医院神经内科,徐州221000

出　　处：《国际脑血管病杂志》2024年第11期827-831,共5页International Journal of Cerebrovascular Diseases

基　　金：上海申康医院发展中心技术规范化管理和推广项目(SHDC22024236);徐州市卫生健康委科技项目(XWKYHT20220084);徐州市科技项目(KC23166);彭城英才-青年医学后备人才培养项目(XWRCHT20220010)。

摘　　要：目的:探讨血清β2微球蛋白(β2-microglobulin,β2M)与急性缺血性卒中(acute ischemic stroke,AIS)患者卒中严重程度以及发病后3个月时转归的相关性。方法:回顾性纳入2018年1月至2022年5月期间徐州医科大学附属市立医院神经内科收治的首次发病的AIS患者。根据入院时美国国立卫生研究院卒中量表评估卒中严重程度,≤8分定义为轻度卒中,>8分定义为中重度卒中。在发病后3个月时采用改良Rankin量表评估临床转归,≤2分定义为转归良好,>2分定义为转归不良。采用多变量logistic回归分析确定β2M与卒中严重程度以及转归的相关性。结果:共纳入463例AIS患者,男性263例(56.68%),年龄(62.89±11.77)岁。其中,轻度卒中组319例(68.89%),中重度卒中组144例(31.10%);转归良好组304例(65.66%),转归不良组159例(34.34%)。单变量分析显示,中重度卒中组和转归不良组β2M分别显著高于轻度卒中组和转归良好组(P均<0.05)。多变量logistic回归分析显示,β2M是AIS患者卒中严重程度(优势比2.476,95%置信区间1.621~3.783;P<0.001)和转归不良(优势比5.179,95%置信区间2.941~11.121;P<0.001)的独立影响因素。结论:较高的血清β2M与AIS患者的卒中严重程度以及转归不良存在显著独立相关性。Objective:To investigate associations of serumβ2-microglobulin(β2M)with baseline stroke severity and outcome at 3 months after onset in patients with acute ischemic stroke(AIS).Methods:Patients with first-ever AIS admitted to the Department of Neurology,the Affiliated Municipal Hospital of Xuzhou Medical University from January 2018 to May 2022 were included retrospectively.The severity of stroke was evaluated according to the National Institute of Health Stroke Scale score at admission.≤8 was defined as mild stroke,and>8 was defined as moderate to severe stroke.At 3 months after onset,the modified Rankin Scale was used to evaluate the clinical outcome,≤2 points was defined as good outcome and>2 points was defined as poor outcome.Multivariate logistic regression analysis was used to determine associations ofβ2M with the severity and outcome of stroke.Results:A total of 463 patients with AIS were enrolled,including 263 males(56.68%),aged 62.89±11.77 years.There were 319 patients(68.89%)in the mild stroke group and 144(31.10%)in the moderate to severe stroke group;304 patients(65.66%)in the good outcome group and 159(34.34%)in the poor outcome group.Univariate analysis showed that theβ2M in the moderate to severe stroke group and the poor outcome group were significantly higher than those in the mild stroke group and the good outcome group,respectively(all P<0.05).Multivariate logistic regression analysis showed thatβ2M was an independent influencing factor for stroke severity(odds ratio 2.476,95%confidence interval 1.621-3.783;P<0.001)and poor outcome(odds ratio 5.179,95%confidence interval 2.941-11.121;P<0.001)in patients with AIS.Conclusion:There is a significant independent correlation between high serumβ2M and the severity and poor outcome of stroke in patients with AIS.

关 键 词：缺血性卒中 Β2微球蛋白 疾病严重程度指数 治疗结果 危险因素 生物标志物 

分 类 号：R743.3[医药卫生—神经病学与精神病学]