摘要
目的:探讨并分析血清缺氧诱导因子-1α(HIF-1α)、血清卵泡抑素样蛋白-1(FSTL1)、急性脑梗死静脉溶栓后症状性脑血流量(CBF)、出血风险评分(SITS评分)与缺血性脑卒中溶栓后出血转化(HT)的关系。方法:选取2018年7月-2020年7月在本院确诊的96例缺血性脑卒中患者,在溶栓治疗24 h后进行头部磁共振检查,根据静脉溶栓后24 h内是否发生HT,将患者分为HT组(24例)和非HT组(72例)。记录患者性别、年龄、合并基础病史等一般资料,采用Logistic回归分析影响患者HT的危险因素,使用头部CT血管造影(CTA)技术测量患者CBF,记录SITS评分,采用酶联免疫吸附实验(ELISA)检测患者HIF-1α、FSTL1水平,采用ROC分析HIF-1α、FSTL1、SITS、CBF对HT的预测价值。结果:两组年龄、合并糖尿病、高血压、溶栓时间、NIHSS、SITS评分、HIF-1α、FSTL1、CBF水平比较,差异均有统计学意义(P<0.05)。Logistic回归模型分析显示HIF-1α≥57 pg/ml、FSTL1≥7 ng/ml、SITS≥7分、CBF<50 ml/100 (g·min)是影响患者HT的独立危险因素。HT组HIF-1α、FSTL1、SITS评分均高于非HT组,CBF低于非HT组,差异均有统计学意义(P<0.05)。ROC结果显示,HIF-1α、FSTL1、SITS、CBF及其联合检测的AUC分别为0.715、0.653、0.741、0.610、0.849。结论:HIF-1α、FSTL1、SITS评分、CBF与缺血性脑卒中溶栓后HT的关系密切相关,临床可通过检测相关水平的变化评估患者HT发生风险。
Objective:To explore and analyze the relationship between serum hypoxia-inducible factor-1α (HIF-1α),follistain-like protein 1 (FSTL1),cerebral blood flow (CBF),score of safe implementation of treatments in stroke (SITS),and hemorrhagic transformation (HT) in ischemic stroke after thrombolysis.Method:A total of 96 patients with ischemic stroke confirmed in the hospital from July 2018 to July 2020 were selected.All underwent head magnetic resonance imaging examination at 24 h after thrombolysis.According to presence or absence of HT within 24 h after intravenous thrombolysis,they were divided into HT group (24 cases) and non-HT group (72 cases).The general data such as gender,age and histories of underlying diseases were recorded.The influencing factors of HT were analyzed by Logistic regression analysis.CBF was measured by CT angiography (CTA).SITS score was recorded.The levels of HIF-1α and FSTL1 were detected by enzyme-linked immunosorbent assay (ELISA).The predictive value of HIF-1α,FSTL1,SITS and CBF for HT was analyzed by ROC curves.Result:There were statistically significant differences in age,diabetes,hypertension,thrombolysis time,NIHSS,SRIFF score,HIF-1α,FSTL1 and CBF levels (P<0.05).Logistic regression model analysis showed that HIF-1α ≥57 pg/ml,FSTL1 ≥7 ng/ml,SITS ≥7 points and CBF< 50 ml/100 (g·min) were independent risk factors for HT in patients.HIF-1α,FSTL1 and SITS score in the HT group were higher than those in the non-HT group,while CBF in the HT group was lower than that in the non-HT group,the differences were statistically significant (P<0.05).ROC results showed that AUC values of HIF-1α,FSTL1,SITS,CBF and combined detection were 0.715,0.653,0.741,0.610 and 0.849 respectively.Conclusion:HIF-1α,FSTL1,SITS score and CBF are closely related to HT in ischemic stroke after thrombolysis.Clinically,the risk of HT can be assessed by detecting their changes.
作者
梁国聪
陈军
林力峰
张惠婷
潘剑罡
LIANG Guocong;CHEN Jun;LIN Lifeng;ZHANG Huiting;PAN Jiangang(The Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,China;不详)
出处
《中外医学研究》
2021年第34期48-52,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
湛江市科技计划项目(2020B01411)。
