摘要
目的探讨急性大动脉粥样硬化型脑梗死(ALAACI)患者血清骨膜蛋白(Periostin)、能量平衡相关蛋白(Adropin)与神经功能缺损和预后的关系。方法检测153例ALAACI患者(ALAACI组)和105例健康体检者(正常对照组)的血清Periostin、Adropin水平。通过Spearman相关性分析探讨血清Periostin、Adropin水平与NIHSS评分的关系,采用ROC曲线分析血清Periostin、Adropin水平对ALAACI患者不良预后的预测价值,采用多因素Logistic回归分析探讨患者不良预后的因素。结果与正常对照组比较,ALAACI组血清Adropin水平显著降低(t=15.795,P<0.001),血清Periostin水平显著升高(t=-23.593,P<0.001)。Spearman相关性分析显示,ALAACI组血清Periostin水平与NIHSS评分呈正相关(rs=0.771,P<0.001),Adropin水平与NIHSS评分呈负相关(rs=-0.734,P<0.001)。与良好预后亚组比较,不良预后亚组年龄、梗死面积、NIHSS评分及Periostin水平显著升高,Adropin水平显著降低(均P<0.01)。Logistic回归分析显示,梗死面积大、NIHSS评分高、Periostin高为ALAACI患者不良预后的独立危险因素(OR=1.988,95%CI:1.385~2.852,P<0.001;OR=1.139,95%CI:1.072~1.211,P<0.001;OR=1.679,95%CI:1.335~2.113,P<0.001),Adropin高为独立保护因素(OR=0.939,95%CI:0.911~0.968,P<0.001)。ROC曲线显示,血清Periostin联合Adropin预测的曲线下面积为0.873,显著高于血清Periostin、Adropin单独预测的0.783、0.786(Z=3.087,P=0.002;Z=2.892,P=0.004)。结论血清Periostin水平升高、Adropin水平降低与ALAACI患者神经功能缺损加重和不良预后有关,二者联合检测对ALAACI患者不良预后的预测价值较高。
Objective To investigate the relationship between serum Periostin,energy balance related protein(Adropin)and neurological deficit and prognosis in patients with acute large artery atherosclerotic cerebral infarction(ALAACI).Methods The serum levels of Periostin and Adropin were detected in 153 patients with ALAACI(ALAACI group)and 105 healthy subjects(normal control group).The correlation between serum Periostin and Adropin levels and NIHSS score was analyzed by Spearman correlation analysis.The predictive value of serum Periostin and Adropin levels on poor prognosis in ALAACI patients was analyzed by ROC curve.The poor prognosis factors in patients were analyzed by multivariate Logistic regression analysis.Results Compared with those in the normal control group,serum Adropin level in the ALAACI group was significantly lower(t=15.795,P<0.001),and Periostin level was significantly higher(t=-23.593,P<0.001).Spearman correlation analysis showed that serum Periostin level was positively correlated with NIHSS scores in the ALAACI group(rs=0.771,P<0.001)and Adropin level in the ALAACI group was negatively correlated with NIHSS scores(rs=-0.734,P<0.001).Compared with those in the good prognosis subgroup,age,infarct area,NIHSS score,and Periostin level in the poor prognosis subgroup were significantly higher,and Adropin level was significantly lower(all P<0.01).Logistic regression analysis showed that large infarct area,high NIHSS score,and high Periostin level were independent risk factors for poor prognosis in patients with ALAACI(OR=1.988,95%CI:1.385-2.852,P<0.001;OR=1.139,95%CI:1.072-1.211,P<0.001;OR=1.679,95%CI:1.335-2.113,P<0.001),and high Adropin level was an independent protective factor(OR=0.939,95%CI:0.911-0.968,P<0.001).The ROC curve showed that the areas under curve(AUC)predicted by serum Periostin in combination with Adropin was 0.873,which was significantly higher than the AUC predicted by serum Periostin and Adropin alone,which were 0.783 and 0.786(Z=3.087,P=0.002;Z=2.892,P=0.004).Conclusion The increase of serum Periostin level and the decrease of Adropin level are related to the aggravation of neurological deficit and poor prognosis in patients with ALAACI,and the combined detection of the two has a high predictive value for the poor prognosis of patients with ALAACI.
作者
刘倩
景瑞
LIU Qian;JING Rui(Department of Neurology,Baoji People's Hospital,Baoji 721000,China)
出处
《临床神经病学杂志》
2025年第1期17-22,共6页
Journal of Clinical Neurology
基金
陕西省卫生健康科研项目立项项目(2021B009)。
关键词
急性大动脉粥样硬化型脑梗死
骨膜蛋白
能量平衡相关蛋白
神经功能缺损
预后
acute large artery atherosclerotic cerebral infarction
periostin
energy balance related protein
neurological deficit
prognosis
