摘要
目的探讨同型半胱氨酸(Homocysteine,Hcy)、胰岛素样生长因子-1(Insulin-like growth factor-1,IGF-1)、miR-195与脑梗死恢复期患者应用补中益气汤加减辅助治疗疗效及预后的关系。方法选取2018年1月—2021年1月期间驻马店市中医收治的脑梗死恢复期患者118例作为研究对象,均给予补中益气汤加减辅助治疗14 d,根据临床疗效分为治愈组24例、显效组39例、有效组46例、无效组9例;另对患者进行1年随访,通过改良Rankin评分量表(ModifiedRankin Scale,mRS)评估患者预后情况,mRS评分≤2分为预后良好组96例,mRS评分>2分为预后不良组22例。比较各组不同疗效Hcy、IGF-1、miR-195水平,采用Spearman法分析脑梗死恢复期患者血清Hcy、IGF-1及miR-195水平与疗效的相关性,多因素Logistic回归分析脑梗死恢复期补中益气汤加减辅助治疗预后的影响因素,并绘制受试者工作特征(ROC)曲线分析Hcy、IGF-1及miR-195预测脑梗死恢复期补中益气汤加减辅助治疗预后不良的价值。结果118例患者经治疗后治愈的有24例,显效有39例,有效有46例,无效有9例,临床总有效率为92.37%(P<0.05)。与无效组比较,治愈组、显效组、有效组患者的Hcy、miR-195均更低、IGF-1均更高,差异有统计学意义(P<0.05);Spearman相关性分析结果显示,Hcy、miR-195与疗效呈负相关,IGF-1与疗效呈正相关,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,Hcy、miR-195是脑梗死恢复期补中益气汤加减辅助治疗预后不良的独立危险因素,而IGF-1是保护因素(P<0.05);ROC曲线分析显示,Hcy、IGF-1及miR-195及三者联合检测的曲线下面积(AUC)分别为0.865、0.802、0.782、0.903。结论Hcy、IGF-1及miR-195水平与脑梗死恢复期补中益气汤加减辅助治疗疗效密切相关,且对预后具有一定的预测价值,可作为疗效及预后不良的预测因子。
Objective To investigate the relationship between homocysteine(Hcy),insulin-like growth factor-1(IGF-1),miR-195 and the efficacy and prognosis of complementary treatment of cerebral infarction during the recovery period with modified Buzhong Yiqi Decoction.Methods From January 2018 to January 2021,118 patients with cerebral infarction in the recovery period admitted to Zhumadian Hospital of Traditional Chinese Medicine were selected as the research objects.All patients were treated with Buzhong Yiqi Decoction for 14 days.According to the clinical efficacy,they were divided into cure group(n=24),significant effect group(n=39),effective group(n=46),and ineffective group(n=9).Patients were followed up for one year,and the prognosis of patients was evaluated by a modified Rankin scale(mRS).Patients with an mRS score of≤2 were divided into the good prognosis group(n=96),and those with an mRS score of>2 were divided into the poor prognosis group(n=22).The levels of Hcy,IGF-1,and miR-195 in different groups were compared.The Spearman method was used to analyze the correlation between serum levels of Hcy,IGF-1,and miR-195 and therapeutic effects in patients with cerebral infarction during the recovery period.Multivariate Logistic regression analysis was used to analyze the factors affecting the prognosis of complementary treatment of cerebral infarction during the recovery period with modified Buzhong Yiqi Decoction.The receiver operating characteristic(ROC)curve was drawn to analyze the value of Hcy,IGF-1,and miR-195 in predicting the poor prognosis of complementary treatment of cerebral infarction during the recovery period with modified Buzhong Yiqi Decoction.Results Among the 118 patients,24 cases were cured;39 cases had obvious effects;46 cases underwent effective treatment,and nine cases underwent ineffective treatment.The total clinical effective rate was 92.37%(P<0.05).Compared with the ineffective group,the Hcy and miR-195 levels were lower,and IGF-1 levels were higher in the cured group,significantly effectiv
作者
梁艳
吕哲
徐晓玉
LIANG Yan;LYU Zhe;XU Xiao-yu(Department of Brain,Zhumadian Hospital of Tradit ional Chinese Medicine,Zhumadian Henan 463000)
出处
《世界中西医结合杂志》
2023年第12期2461-2466,共6页
World Journal of Integrated Traditional and Western Medicine
基金
2019年度河南省医学科技攻关计划(LHGJ20190986)。
