血清SGK1和CXCR7水平对首发急性缺血性脑卒中患者短期预后的预测价值  

Predictive value of serum glucocorticoid regulated kinase 1(SGK1)and CXC motif chemokine receptor 7(CXCR7)levels for short-term prognosis in patients with first onset acute ischemic stroke(AIS)

作　　者：钱静娟 汪拂宇 宋春杰[1] 徐峰 QIAN Jingjuan;WANG Fuyu;SONG Chunjie;XU Feng(Department of Neurology,Suqian First Hospital,Suqian Jiangsu 223800,China)

机构地区：[1]江苏省人民医院宿迁医院/宿迁市第一人民医院神经内科,江苏宿迁223800

出　　处：《新疆医科大学学报》2025年第4期509-515,共7页Journal of Xinjiang Medical University

基　　金：2023年江苏省卫健委科研资助项目(M2022098)。

摘　　要：目的探讨血清和糖皮质激素调节激酶1(SGK1)和CXC基序趋化因子受体7(CXCR7)水平对首发急性缺血性脑卒中(Acute ischemic stroke,AIS)患者短期预后的预测价值。方法选择2023年1月至2024年3月本院收治的228例首发AIS患者为病例组,选择同期在本院接受健康体检者80例为健康对照组。按照AIS患者发病后90 d的预后情况分为预后良好组和预后不良组,比较两组患者基线资料与实验室检测指标,采用多因素Logistic回归分析影响首发AIS患者预后不良的相关因素。绘制受试者工作特征(ROC)曲线分析血清SGK1和CXCR7水平对首发AIS患者预后不良的预测价值。结果与健康对照组比较,病例组血清SGK1水平显著增高,而CXCR7水平显著降低,差异有统计学意义(P<0.05)。与预后良好组比较,预后不良组患者年龄偏大,发病至入院时间偏长,入院时舒张压、NIHSS评分、C反应蛋白、纤维蛋白原、D-二聚体、LDL-C、SGK1水平偏高,血清白蛋白、CXCR7水平偏低,差异有统计学意义(P<0.05)。Spearman相关性分析显示,SGK1水平与mRS评分呈正相关(r=0.285,P<0.05),CXCR7水平与mRS评分呈负相关(r=-0.276,P<0.05)。多因素Logistic回归分析显示,血清SGK1水平升高是首发AIS患者短期预后不良的独立危险因素,CXCR7水平升高为独立保护因素。ROC曲线分析显示,血清SGK1和CXCR7水平预测首发AIS患者短期预后不良的曲线下面积(AUC)分别为0.815、0.748,灵敏度分别为77.79%和70.11%;特异度分别为82.81%和84.40%,最佳诊断值分别为42.18 ng/L和129.36 ng/L。两者联合预测的AUC为0.906,明显高于两者单独预测(Z分别为3.143和4.281,P均<0.05)。结论与健康成年人比较,首发AIS患者血清SGK1水平增高,CXCR7水平降低,高水平SGK1和低水平CXCR7均是首发AIS患者短期预后的影响因素,两者联合检测对此类患者短期预后不良具有良好的预测价值。Objective To investigate the predictive value of serum and glucocorticoid regulated kinase 1(SGK1)and CXC motif chemokine receptor 7(CXCR7)levels for short-term prognosis in patients with first onset acuteischemic stroke(AIS).Method A total of 228 patients with first onset AIS admitted to the hospital from January 2023 to March 2024 were selected as case group,and 80 patients who underwent health examinations in the hospital during the same period were selected as healthy control group.According to the prognosis of AIS patients 90 days after onset,the patients were divided into a good prognosis group and a poor prognosis group.The baseline data and laboratory test indicators of the 2 groups of the patients were compared,and multiple Logistic regression analysis was used to identify the relevant factors affecting the poor prognosis of first onset AIS patients.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum SGK1 and CXCR7 levels for poor prognosis in patients with first-stage AIS.Results Compared with the healthy control group,the serum SGK1 level in the case group was significantly increased,while the CXCR7 level was significantly decreased,and the difference was statistically significant(P<0.05).Compared with the group with good prognosis,the group with poor prognosis had older age,longer time from onset to admission,higher admission diastolic blood pressure,NIHSS score,C-reactive protein,fibrinogen,D-dimer,LDL-C,and SGK1 levels and lower serum albumin and CXCR7 levels,with statistically significant differences(P<0.05).Spearman correlation analysis showed that SGK1 levels were positively correlated with mRS scores(r=0.285,P<0.05),while CXCR7 levels were negatively correlated with mRS scores(r=-0.276,P<0.05).Multivariate Logistic regression analysis showed that elevated serum SGK1 levels were an independent risk factor for poor short-term prognosis in patients with initial AIS,while elevated CXCR7 levels were an independent protective factor.ROC curve analysis showe

关 键 词：血清糖皮质激素调节激酶1 CXC基序趋化因子受体7 急性缺血性脑卒中 预后 改良Rankin量表 预测价值 

分 类 号：R34[医药卫生—基础医学]