摘要
目的探讨血清脑钠肽(BNP)、脂肪因子趋化素(Chemerin)与重组组织型纤溶酶原激活物(rt-PA)静脉溶栓脑梗死患者预后的相关性。方法选取河南科技大学第一附属医院2014-07—2019-03采用rt-PA静脉溶栓治疗的脑梗死患者90例,溶栓治疗后随访90 d,采用Rankin量表(mRS)评估患者预后,将mRS≤2分定义为功能结局预后良好组,将mRS>2分患者定义为预后不良组,比较2组血清BNP、Chemerin水平,通过Pearson相关性分析血清BNP、Chemerin与mRS评分的相关性,分析rt-PA静脉溶栓患者预后的影响因素。结果90例患者随访90 d,预后良好者58例,预后不良者32例,预后良好组血清BNP、Chemerin含量低于预后不良组(P<0.05);Logisitic回归分析显示,年龄、颈部大血管狭窄≥50%、OSCP分型、溶栓前NIHSS评分、OTT时间、BNP含量、Chemerin含量是影响脑梗死rt-PA静脉溶栓患者预后的独立危险因素;Pearson相关性分析显示,血清BNP、Chemerin水平与mRS评分呈正相关(r=0.345、0.364,P<0.05);血清BNP、Chemerin联合检测预测患者预后状态ROC曲线下面积为0.860,高于单独BNP、Chemerin判断曲线下面积0.758、0.760(P<0.05)。结论血清BNP、Chemerin是rt-PA静脉溶栓脑梗死患者预后的影响因素,与患者mRS评分呈正相关,可作为患者预后的辅助评估指标。
Objective To explore the correlation between serum brain natriuretic peptide(BNP),adipokine chemerin(Chemerin)and prognosis in cerebral infarction patients undergoing intravenous thrombolysis of recombinant tissue plasminogen activator(rt-PA).Methods Ninety cerebral infarction patients who underwent rt-PA intravenous thrombolysis in the hospital from July 2018 to March 2019 were enrolled.After completion of rt-PA intravenous thrombolysis,they were followed up for 90 days.Their prognosis was evaluated by modified Rankin Scale(mRS).The patients with mRS score not higher than 2 points were included in good prognosis group,while those with mRS score higher 2 points were included in poor prognosis group.The levels of serum BNP and Chemerin were compared between the two groups.The correlation between serum BNP,Chemerin and mRS scores was analyzed by Pearson correlation analysis.The influencing factors of prognosis in patients undergoing rt-PA intravenous thrombolysis were analyzed.Results The 90 patients were followed up for 90 days.There were 58 cases with good prognosis and 32 cases with poor prognosis.The levels of serum BNP and Chemerin in good prognosis group were lower than those in poor prognosis group(P<0.05).Logisitic regression analysis showed that age,major cervical vessels stenosis not lower than 50%,OSCP classifications,NIHSS score before thrombolysis,OTT time,levels of BNP and Chemerin were independent risk factors that affected the prognosis.Pearson correlation analysis showed that levels of serum BNP and Chemerin were positively correlated with mRS score(r=0.345,0.364,P<0.05).The area under the ROC curve(AUC)of serum BNP combined with Chemerin for predicting prognosis status was higher than that of BNP and Chemerin alone(0.860 vs 0.758,0.760,P<0.05).Conclusion Serum BNP and Chemerin are the influencing factors of prognosis in cerebral infarction patients undergoing rt-PA intravenous thrombolysis,which are positively correlated with mRS scores,and they can be applied as auxiliary evaluation indexes of pr
作者
赵鑫
胡莹莹
李燕春
ZHAO Xin;HU Yingying;LI Yanchun(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)
出处
《中国实用神经疾病杂志》
2020年第21期1878-1884,共7页
Chinese Journal of Practical Nervous Diseases
基金
河南省医学科技攻关项目(编号:201702354)。
关键词
脑梗死
重组组织型纤溶酶原激活物
脑钠肽
脂肪因子趋化素
预后
Cerebral infarction
Recombinant tissue plasminogen activator
Brain natriuretic peptide
Adipokine chemerin
Prognosis
