摘要
目的探讨急性脑梗死(ACI)患者血清泛素羧基末端水解酶-1(UCH-L1)、衰老关键蛋白抗原-5(Fibulin-5)水平变化及临床意义。方法选取138例ACI患者(ACI组)和100例查体健康者(对照组),采用改良Rankin量表(mRS)评估ACI患者发病后90 d临床转归。采用双抗体夹心化学发光法检测血清UCH-L1、Fibulin-5水平,Pearson相关性分析UCH-L1、Fibulin-5与梗死面积、美国国立卫生院神经功能缺损评分(NIHSS)、简易智能精神状态检查(MMSE)、mRS评分的相关性,单因素和多因素Logistic回归分析UCH-L1、Fibulin-5与ACI患者不良临床转归的关系。采用受试者工作特征(ROC)曲线分析UCH-L1、Fibulin-5预测ACI患者不良临床转归的价值。结果ACI组血清UCH-L1、Fibulin-5水平均高于对照组(P均<0.05)。血清UCH-L1、Fibulin-5水平随ACI患者梗死面积增加、神经缺损程度加重而升高(P均<0.05),认知功能异常者血清UCH-L1水平高于认知功能正常者(P<0.05),临床转归不良者血清UCH-L1、Fibulin-5水平高于临床转归良好者(P均<0.05)。相关性分析结果显示,ACI患者血清UCH-L1、Fibulin-5水平均与梗死面积、NIHSS评分、mRS评分呈正相关(r分别为0.513、0.416、0.591;0.526、0.492、0.601,P均<0.05),血清UCH-L1与MMSE评分呈负相关(r=-0.506,P<0.05)。多因素Logistic回归分析显示,梗死面积、NHISS评分、UCH-L1、Fibulin-5水平均与ACI不良临床转归的发生独立相关(P均<0.05)。ROC曲线分析结果显示,血清UCH-L1、Fibulin-5、联合UCH-L1+Fibulin-5预测ACI不良临床转归的曲线下面积(AUC)分别为0.860、0.741、0.947。结论ACI患者血清UCH-L1、Fibulin-5水平升高,二者与梗死面积、神经缺损程度和临床转归有关,UCH-L1水平与认知功能受损有关;检测血清UCH-L1、Fibulin-5有助于ACI患者临床转归的预测。
Objective To investigate the changes of serum ubiquitin C-terminal hydrolase-L1(UCH-L1)and Fibulin-5 in patients with acute cerebral infarction(ACI)and clinical significance.Methods Totally 138 ACI patients(ACI group)and 100 outpatients(control group)were detected.The clinical outcome 90 days after onset of ACI was assessed by modified Rankin scale(mRS).Serum UCH-L1 and Fibulin-5 levels were detected by double-antibody sandwich chemiluminescence assay.Pearson correlation analyzed the relation between UCH-L1,Fibulin-5 and infarct size,National Institutes of Health Stroke Scale(NIHSS)score,Mini-Mental State Examination(MMSE),and mRS score.Univariate and multivariate Logistic regression were used to analyze the relationship between UCH-L1,Fibulin-5 and adverse clinical outcomes in ACI patients.Receiver operating characteristic(ROC)curve was used to analyze the value of UCH-L1 and Fibulin-5 in predicting adverse clinical outcomes in ACI patients.Results The levels of serum UCH-L1 and Fibulin-5 in the ACI group were higher than those in the control group(both P<0.05).The levels of serum UCH-L1 and Fibulin-5 increased with the increase of infarct area and the severity of neurological deficit degree(both P<0.05).The level of serum UCH-L1 in the group with abnormal cognitive function was higher than that in the normal group(P<0.05).The levels of UCH-L1 and Fibulin-5 in the group with poor clinical outcome were higher than those in the group with good clinical outcome(both P<0.05).The results of correlation analysis showed that the levels of serum UCH-L1 and Fibulin-5 were positively correlated with infarct area,NIHSS score and mRs score(r=0.513,0.416,0.591;0.526,0.492,0.601;both P<0.05),and serum UCH-L1 was negatively correlated with MMSE score(r=-0.506,P<0.05).Multivariate Logistic regression analysis showed that infarct area,NHISS score,UCH-L1,Fibulin-5 levels were all independently related to the poor clinical outcome of ACI(all P<0.05).ROC analysis showed that the area under the curve(AUC)of UCH-L1,Fibulin-5,and combined UCH-L1+Fibulin-5 in predicting poor clinical outcome of ACI was 0.860,0.741,and 0.947,respectively.Conclusions The levels of serum UCH-L1 and Fibulin-5 increase in patients with ACI,and they are related to the infarct area,neurological deficit degree and clinical outcome.The level of UCH-L1 is related to the cognitive impairment.UCH-L1 and Fibulin-5 can be used as predictive indicators of poor clinical outcomes in patients with ACI.
作者
单海雷
焦光美
程曦
马征
高燕军
杨宁
窦志杰
SHAN Hailei;JIAO Guangmei;CHENG Xi;MA Zheng;GAO Yanjun;YANG Ning;DOU Zhijie(The Affiliated Hospital of Chengde Medical University,Chengde 067000,China)
出处
《山东医药》
CAS
2021年第7期32-36,共5页
Shandong Medical Journal
基金
河北省医学科学研究重点课题(20181160)。
