摘要
目的分析血清神经丝轻链(NFL)、磷酸化神经丝重链(pNFH)水平与急性缺血性脑卒中(AIS)患者病情及预后的关系。方法选择2018年5月—2020年12月延安大学附属医院神经内科收治AIS患者113例为AIS组,根据入院当日美国国立卫生研究院卒中量表(NIHSS)评分分为轻症亚组(NIHSS评分<6分,36例)、中症亚组(6分≤NIHSS评分<14分,47例)、重症亚组(NIHSS评分≥14分,30例);根据出院90 d后改良Rankin量表(mRS)评分分为预后良好亚组(mRS评分0~2分,85例)、预后不良亚组(mRS评分≥3分,28例)。另选择于门诊体检的正常者106例为健康对照组。检测2组受试者血清NFL、pNFH水平,分析血清NFL、pNFH水平与AIS患者预后的关系。结果AIS组血清NFL、pNFH水平均高于健康对照组(t=26.613、50.727,P均=0.000),重症亚组>中症亚组>轻症亚组(F=49.457、71.213,P均=0.000)。预后不良亚组患者年龄、高血压患者比例、糖尿病患者比例、入院时NIHSS评分及血清FPG、CRP、TNF-α、NFL、pNFH均高于预后良好亚组,差异有统计学意义(χ^(2)/t/P=3.076/0.003、4.517/0.034、7.170/0.007、9.093/0.000、2.217/0.029、2.332/0.022、2.612/0.010、5.123/0.000、6.179/0.000)。Logistic多因素回归分析结果显示,高NIHSS评分,高血清NFL、pNFH水平是AIS预后不良的危险因素[OR(95%CI)=1.927(1.294~2.869)、1.626(1.149~2.300)、1.654(1.204~2.272)]。血清NFL、pNFH预测AIS患者预后的曲线下面积为0.686、0.732,二者联合为0.903,高于单独NFL、pNFH预测(z=3.258、3.015,P均=0.000)。结论AIS患者血清NFL和pNFH水平均升高,且与AIS患者病情严重程度及预后有关。
Objective To analyze the relationship between serum neurofilament light chain(NFL),phosphorylated neurofilament heavy chain(pNFH)levels and the condition and prognosis of patients with acute ischemic stroke(AIS).Methods One hundred and thireteen AIS patients admitted to the Department of Neurology,Affiliated Hospital of Yan’an University from May 2018 to December 2020 were selected as the AIS group.According to the National Institutes of Health Stroke Scale(NIHSS)score on the day of admission,it was divided into mild subgroup(NIHSS score<6 points,36 cases),moderate subgroup(6 points≤NIHSS score<14 points,47 cases),Severe subgroup(NIHSS score≥14 points,30 cases).According to the modified Rankin Scale(mRS)score 90 days after discharge from the hospital,they were divided into a good prognosis subgroup(mRS score 0-2 points,85 cases)and a poor prognosis subgroup(mRS score≥3 points,28 cases).In addition,106 normal patients who were selected in the outpatient physical examination were selected as the healthy control group.Serum NFL and pNFH levels were detected in the two groups of subjects,and the relationship between serum NFL and pNFH levels and the prognosis of AIS patients was analyzed.Results In comparison of serum NFL and pNFH levels,the AIS group was higher than the healthy control group(t=26.613,50.727,P=0.000),severe subgroup>moderate subgroup>light subgroup(F=49.457,71.213,P=0.000).The age of the poor prognosis subgroup,the proportion of hypertension patients,the proportion of diabetic patients,the NIHSS score at admission and the serum FPG,CRP,TNF-α,NFL,and pNFH were all higher than those of the good prognosis subgroup,and the difference was statistically significant(χ^(2)/t/P=3.076/0.003,4.517/0.034,7.170/0.007,9.093/0.000,2.217/0.029,2.332/0.022,2.612/0.010,5.123/0.000,6.179/0.000).Logistic multivariate regression analysis showed that high NIHSS score,high serum NFL and pNFH levels are risk factors for poor prognosis of AIS[OR(95%CI)=1.927(1.294-2.869),1.626(1.149-2.300),1.654(1.204-2.272)].The a
作者
郭改艳
王柳毅
吴瑞
师强
刘文慧
郝涛
Guo Gaiyan;Wang Liuyi;Wu Rui;Shi Qiang;Liu Wenhui;Hao Tao(Department of Neurology,Affiliated Hospital of Yan’an University,Shaanxi Province,Yan'an 716000,China;不详)
出处
《疑难病杂志》
CAS
2022年第3期252-256,262,共6页
Chinese Journal of Difficult and Complicated Cases
基金
陕西省科学技术研究发展计划(2019JM533)。
关键词
急性缺血性脑卒中
神经丝轻链
磷酸化神经丝重链
美国国立卫生研究院卒中量表
预后
Acute ischemic stroke
Neurofilament light chian
Phosphorylated neurofilament heavy chain
National Institutes of Health Stroke Scale
Prognosis
