摘要
目的探讨急性脑梗死(ACI)患者血清相关细胞因子水平变化,分析其对阿替普酶(rt-PA)静脉溶栓后脑出血转化的影响。方法选取2018年6月至2020年6月周口市第一人民医院收治的89例ACI患者,所有患者均行rt-PA静脉溶栓,于溶栓后24 h行头颅MRI检查,根据是否发生脑出血转化分为转化组(16例)、非转化组(73例),均检测溶栓后12 h、24 h血清超敏C反应蛋白(hs-CRP)、D-二聚体、高迁移率族蛋白B1(HMGB1)、补体C1q肿瘤坏死因子相关蛋白-3(CTRP-3)水平,对比两组不同时间脑损伤程度[美国国立卫生研究院卒中量表(NIHSS)],分析ACI患者血清相关细胞因子水平变化与脑损伤程度的相关性。结果转化组溶栓后12 h、24 h血清hs-CRP、D-二聚体、HMGB1水平较未转化组高,血清CTRP-3水平较未转化组低,差异有统计学意义(P<0.05);转化组溶栓后12 h、24 h NIHSS评分均较未转化组高,差异有统计学意义(P<0.05);ACI患者血清hs-CRP、D-二聚体、HMGB1水平与NIHSS评分呈正相关,差异有统计学意义(r_(1)=0.705、r_(2)=0.868、r_(3)=0.826,P<0.05),血清CTRP-3水平与NIHSS评分呈负相关,差异有统计学意义(r=-0.685,P<0.05);溶栓后12 h血清hs-CRP(95%CI:0.725~0.967)、D-二聚体(95%CI:0.693~0.972)、HMGB1(95%CI:0.645~0.923)、CTRP-3(95%CI:0.824~0.902)水平评估ACI患者rt-PA静脉溶栓后脑出血转化的AUC、灵敏度、特异度均较高。结论血清相关细胞因子水平变化与ACI患者rt-PA静脉溶栓后脑出血转化具有相关性,通过检测相关因子水平可评估ACI患者病情及预后,有利于减少脑出血转化发生率,制定后期治疗方案,促进疾病转归。
Objective To investigate the changes of serum-related cytokine levels in patients with acute cerebral infarction(ACI)and analyze their effects on the transformation of cerebral hemorrhage after intravenous thrombolysis with alteplase(rtPA).Methods A total of 89 ACI patients admitted to The First People's Hospital of Zhoukou city from June 2018 to June 2020 were selected.All patients received INTRAVENOUS thrombolytic therapy with RT-PA,and cranial MRI examination was performed 24 h after thrombolytic therapy.According to the occurrence of cerebral hemorrhage transformation,they were divided into transformed group(16 cases)and non-transformed group(73 cases).Serum hS-CRP,D-dimer,high mobility group protein B1(HMGB1)and complement C1q tumor necrosis factor related protein-3(CTRP-3)levels were detected at 12 h and 24 h after thrombolytic therapy.The degree of brain injury at different time was compared between the two groups[National Institutes of Health Stroke Scale(NIHSS)],and the correlation between the changes of serum related cytokines and the degree of brain injury in ACI patients was analyzed.Results The levels of hS-CRP,D-dimer and HMGB1 in the transformed group were higher than those in the untransformed group at 12 h and 24 h after embolization,while the levels of CTRP-3 were lower than those in the untransformed group,the differences were statistically significant(P<0.05).NIHSS score of 12 h and 24 h after thrombolysis in the transformed group was higher than that in the non-transformed group,and the difference was statistically significant(P<0.05).In ACI patients,serum hS-CRP,D-dimer and HMGB1 levels were positively correlated with NIHSS score,with statistically significant differences(r_(1)=0.705,r_(2)=0.868,r_(3)=0.826,P<0.05).Serum CTRP-3 levels were negatively correlated with NIHSS score.The difference was statistically significant(r=-0.685,P<0.05).12 h after thrombolytic therapy,serum hS-CRP(95%CI:0.725-0.967),D-dimer(95%CI:0.693~0.972),HMGB1(95%CI:0.645~0.923),CTRP-3(95%CI:The AUC,sensitivity and sp
作者
周彤
何庆
周高领
ZHOU Tong;HE Qing;ZHOU Gaoling(Department of Neurology,Zhoukou first people’s Hospital,Zhoukou Henan 466700,China)
出处
《临床研究》
2022年第6期29-32,共4页
Clinical Research
关键词
急性脑梗死
静脉溶栓
脑出血转化
超敏C反应蛋白
高迁移率族蛋白B1
acute cerebral infarction
intravenous thrombolysis
cerebral hemorrhage transformation
ultrasensitive C-reactive protein
high mobility group protein B1
