摘要
目的分析急性脑梗死(ACI)患者外周血Kelch样环氧氯丙烷相关蛋白⁃1(Keap1)⁃核因子E2相关因子2(Nrf2)/抗氧化反应元件(ARE)信号通路变化与预后的相关性。方法选取2020年6月—2022年3月安徽医科大学附属巢湖医院神经内科诊治ACI患者110例作为研究对象,根据溶栓后3个月的改良Rankin量表(mRs)评分分为近期预后良好组与近期预后不良组,随访1年ACI是否复发分为远期预后良好组与远期预后不良组,比较不同近远期预后组溶栓前、溶栓后7 d、溶栓后3个月外周血Keap1、醌氧化还原酶1(NQO1)、Nrf2、ARE蛋白相对表达量、神经功能缺损(NIHSS)评分,分析各蛋白与NIHSS评分的相关性,受试者工作特征曲线(ROC)评价各蛋白对预后的预测价值。结果110例ACI患者,近期预后良好患者78例,近期预后不良患者32例;随访1年,失访6例,远期预后良好患者83例,远期预后不良患者21例。近远期预后不良组溶栓后7 d、3个月Keap1蛋白相对表达量、NIHSS评分高于近远期预后良好组,NQO1、Nrf2、ARE蛋白相对表达量低于近远期预后良好组(P均<0.001);溶栓后7 d、3个月Keap1蛋白相对表达量与NIHSS评分呈正相关(r=0.684、0.702,P均<0.001),NQO1、Nrf2、ARE蛋白相对表达量与NIHSS评分呈负相关(7 d:r=-0.615、-0.628、-0.609,3个月:r=-0.631、-0.657、-0.629,P均<0.001);溶栓后7 d的Keap1、NQO1、Nrf2、ARE蛋白相对表达量及四者联合预测近期预后的AUC为0.803、0.717、0.800、0.765、0.907,四者联合优于各蛋白单独预测(Z/P=2.105/0.026、2.413/0.004、2.113/0.021、2.205/0.016);溶栓后3个月的Keap1、NQO1、Nrf2、ARE蛋白相对表达量及四者联合预测远期预后不良的AUC为0.766、0.765、0.812、0.767、0.927,四者联合优于各蛋白单独预测(Z/P=2.238/0.010、2.241/0.008、2.115/0.019、2.231/0.012);溶栓后3个月的外周血Keap1⁃Nrf2/ARE蛋白预测远期预后的AUC与溶栓后7 d的外周血Keap1⁃Nrf2/ARE蛋白预测近期预后的A
Objective To investigate the correlation between changes in the Kelch like epichlorohydrin related pro⁃tein 1(Keap1)nuclear factor E2 related factor 2(Nrf2)/antioxidant response element(ARE)signaling pathway in peripheral blood of patients with acute cerebral infarction(ACI)and prognosis.Methods One hundred and ten patients with ACI diag⁃nosed and treated in the Department of Neurology,Chaohu Hospital,Anhui Medical University,from June 2020 to March 2022 were selected as the research subjects.According to the modified Rankin Scale(mRs)scores three months after throm⁃bolysis,they were divided into a group with good short⁃term prognosis and a group with poor short⁃term prognosis.Whether ACI recurred after one year of follow⁃up was divided into a group with good long⁃term prognosis and a group with poor long⁃term prognosis.Different short⁃term and long⁃term prognosis groups were compared before and 7 days after thrombolysis Af⁃ter 3 months of thrombolysis,the relative expression levels of Keap1,quinone oxidoreductase 1(NQO1),Nrf2,ARE proteins,and neurological impairment(NIHSS)scores in peripheral blood were analyzed.The correlation between each protein and NIHSS score was analyzed,and the predictive value of each protein on prognosis was evaluated using the subject operating characteristic curve(ROC).Results One hundred and ten ACI patients,78 with good recent prognosis,and 32 with poor re⁃cent prognosis;Following up for 1 year,6 cases were lost,83 cases had good long⁃term prognosis,and 21 cases had poor long⁃term prognosis.The relative expression level of Keap1 protein and NIHSS score in the group with poor short⁃term and long⁃term prognosis after thrombolysis at 7 days and 3 months were higher than those in the group with good short⁃term and long⁃term prognosis,while the relative expression levels of NQO1,Nrf2,and ARE proteins were lower than those in the group with good short⁃term and long⁃term prognosis(P<0.001).The relative expression of Keap1 protein was positively corre
作者
张欢
祝善尧
葛伟
洪斌
刘爽
Zhang Huan;Zhu Shanyao;Ge Wei;Hong Bin;Liu Shuang(Department of Neu-rology,Chaohu Hospital Affiliated to Anhui Medical University,Hefei Province,Chaohu 238000,China)
出处
《疑难病杂志》
CAS
2023年第6期607-612,619,共7页
Chinese Journal of Difficult and Complicated Cases
基金
安徽高校协同创新项目(GXXT⁃2021⁃083)。
