摘要
目的检测急性脑梗死(ACI)患者中性粒细胞/淋巴细胞比值(NLR)、神经胶质纤维酸性蛋白(GFAP)、CXC型趋化因子配体16(CXCL16)水平,并分析其对机械取栓术后90 d预后的预测价值。方法选取2020年1月至2022年10月于平顶山市第一人民医院行机械取栓术的73例ACI患者为研究对象,依据术后90 d预后情况分为预后良好组(n=42)和预后不良组(n=31)。比较两组患者的临床资料,以及术前、术后7 d、14 d的血清NLR、GFAP、CXCL16水平;采用Spearman法分析血清各指标与血流灌注分级(TIBI)、神经功能损伤、脑梗死体积及预后的相关性,采用受试者工作特征曲线(ROC)及曲线下面积(AUC)分析术后7 d、14 d血清各指标对预后的预测价值。结果术后7 d,预后良好组患者的血清NLR、GFAP、CXCL16水平分别为3.46±1.12、(7.71±2.17)μg/L、(2.07±0.41)μg/L,明显低于预后不良组的4.02±1.14、(9.86±2.28)μg/L、(2.63±0.47)μg/L,术后14 d,预后良好组患者的血清NLR、GFAP、CXCL16水平分别为2.71±0.79、(6.24±1.93)μg/L、(1.72±0.39)μg/L,明显低于预后不良组的3.98±1.13、(9.78±2.26)μg/L、(2.59±0.43)μg/L,差异均有统计学意义(P<0.05);重度损伤患者血清NLR、GFAP、CXCL16水平高于中度损伤、轻度损伤,且中度损伤高于轻度损伤,差异有统计学意义(P<0.05);不同梗死体积患者血清NLR、GFAP、CXCL16水平比较,小梗死<中梗死<大梗死,差异有统计学意义(P<0.05);经Spearman分析结果显示,血清NLR、GFAP、CXCL16水平与TIBI分级呈负相关(P<0.05),而与神经功能损伤、脑梗死体积呈正相关(P<0.05);经偏回归分析结果显示,血清各指标与ACI患者预后显著相关(P<0.05);术后7 d、14 d,血清NLR、GFAP、CXCL16联合预测ACI患者预后的AUC大于单独指标预测(P<0.05)。结论NLR、GFAP、CXCL16与ACI患者神经功能损伤、脑梗死体积存在相关性,联合检测其水平对ACI患者机械取栓后90 d的预后具有一定预测价值。
Objective To investigate the levels of neutrophil/lymphocyte ratio(NLR),glial fibrillary acidic protein(GFAP),and CXC type chemokine ligand 16(CXCL16)in patients with acute cerebral infarction(ACI),and to analyze their predictive value for prognosis 90 days after mechanical embolectomy.Methods Seventy-three patients with ACI who underwent mechanical embolization at Pingdingshan First People's Hospital from January 2020 to October 2022 were selected for the study,which were divided into a good prognosis group(n=42)and a poor prognosis group(n=31)according to their prognosis at 90 d after surgery.The clinical data,serum NLR,GFAP,and CXCL16 levels before surgery,7 d,and 14 d after surgery were compared between the two groups.The correlation between the serum indicators and TIBI,neurological impairment,cerebral infarction volume,and prognosis was analyzed by the Spearman method.The prognostic value of each index in serum at 7 d and 14 d postoperatively was analyzed using receiver operating characteristic curve(ROC)and area under the curve(AUC).Results At 7 d postoperatively,the serum levels of NLR,GFAP,and CXCL16 in the good prognosis group were 3.46±1.12,(7.71±2.17)μg/L,and(2.07±0.41)μg/L,respectively,which were significantly lower than 4.02±1.14,(9.86±2.28)μg/L,and(2.63±0.47)μg/L in the poor prognosis group;at 14 d postoperatively,the serum levels of NLR,GFAP,and CXCL16 in the good prognosis group were 2.71±0.79,(6.24±1.93)μg/L,and(1.72±0.39)μg/L,respectively,which were significantly lower than 3.98±1.13,(9.78±2.26)μg/L,and(2.59±0.43)μg/L in the poor prognosis group;the differences were statistically significant(P<0.05).Serum levels of NLR,GFAP,and CXCL16 were higher in patients with severe injury than those with moderate injury and mild injury,and also higher in patients with moderate injury than those with mild injury,with statistically significant differences(P<0.05).Serum levels of NLR,GFAP,and CXCL16 decreased successively in patients with small infarction volume,medium infarction,and large
作者
王新伟
刘智
王世城
李文
杜迎春
WANG Xin-wei;LIU Zhi;WANG Shi-cheng;LI Wen;DU Ying-chun(The Second Ward,Department of Neurosurgery,Pingdingshan First People's Hospital,Pingdingshan 467000,Henan,CHINA;Medical Department,Pingdingshan University,Pingdingshan 467000,Henan,CHINA;Intensive Care Unit,Pingdingshan First People's Hospital,Pingdingshan 467000,Henan,CHINA)
出处
《海南医学》
CAS
2023年第16期2304-2308,共5页
Hainan Medical Journal
基金
2020年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20200909)。
