摘要
目的探讨急性缺血性脑卒中(AIS)患者血清内皮细胞特异性分子(Endocan),Jun N-末端激酶途径相关磷酸酶(JKAP)水平变化及其与神经功能缺损和近期预后的关系。方法选取2020年1月至2022年1月神经内科住院部收治的192例新诊断AIS患者(AIS组)和50例健康志愿者(对照组),根据NHISS评分将AIS患者分为轻症组(NIHSS评分<6分,n=52)、中症组(6分≤NIHSS评分<14分,n=85)和重症组(NIHSS评分≥14分,n=55)。所有受试者入组后采用酶联免疫吸附试验检测血清Endocan,JKAP水平,比较不同神经缺损程度患者血清Endocan,JKAP水平差异。出院后90 d采用改良Rankin量表(mRS)评估神经预后,收集临床资料,分析影响AIS患者近期预后的因素以及Endocan,JKAP预测AIS患者近期预后的价值。结果AIS组血清Endocan水平高于对照组(P<0.05),JKAP水平低于对照组(P<0.05)。重症组血清Endocan水平高于中、轻症组(P<0.05),JKAP水平低于中、轻症组(P<0.05)。神经预后不良48例,预后良好144例,多因素Logistic回归分析结果显示高NIHSS评分,高水平Endocan是AIS预后不良的危险因素(P<0.05),高水平JKAP是保护因素(P<0.05)。Endocan,JKAP预测AIS患者近期预后的曲线下面积分别为0.773、0.742,联合Endocan,JKAP预测AIS患者近期预后的曲线下面积为0.914,高于单独Endocan,JKAP预测(P<0.05)。结论AIS患者血清Endocan水平增高,JKAP水平下降,且与神经缺损程度加重以及不良预后的发生有关,检测Endocan和JKAP可预测AIS患者预后不良风险。
Objective To investigate the changes in serum Endocan,Jun N-terminal kinase pathway associated phosphatase(JKAP)levels in patients with acute ischemic stroke(AIS)and their correlation with neurological impairment and short-term prognosis.Methods A total of 192 patients with newly diagnosed AIS hospitalized in the Department of Neurology of our hospital from January 2020 to January 2022 were selected in the AIS group.During the same period,50 healthy volunteers were included in the control group.According to the National Institutes of Health Stroke Scale(NIHSS)score,AIS patients were divided into mild group(NIHSS score<6 points,n=52),moderate group(6 points≤NIHSS score<14 points,n=85)and severe group(NIHSS score≥14 points,n=55).After all subjects were enrolled,serum Endocan and JKAP levels were detected by enzymolinked immunosorbent assay,and their differences in AIS patients with nerve defects at varying degrees were compared.At 90 days after discharge,neurological prognosis was assessed using the modified Rankin Scale(mRS).Clinical data were collected to analyze the factors affecting the short-term prognosis of AIS patients and the value of Endocan and JKAP in predicting the short-term prognosis of AIS patients.Results The serum Endocan level in AIS group was significantly higher than that of control group,while JKAP was significantly lower(both P<0.05).The serum Endocan level in severe group was significantly higher than that of the moderate group and mild group,while JKAP was significantly lower(both P<0.05).There were 48 cases with poor neurological prognosis and 144 cases with good neurological prognosis.The results of multivariate Logistic regression analysis showed that high NIHSS score,high level of Endocan were risk factors for poor prognosis of AIS(P<0.05),and high level of JKAP was a protective factor(P<0.05).The area under the curve(AUC)of serum Endocan and JKAP in predicting AIS was 0.773 and 0.742,respectively.The AUC of a combination detection of serum Endocan and JKAP in predicting AIS was 0.9
作者
董国锐
王成
史永龙
DONG Guorui;WANG Cheng;SHI Yonglong(Department of Neurology,Pingliang Second People’s Hospital,Gansu,Pingliang 744000,China;不详)
出处
《河北医药》
CAS
2024年第6期862-865,869,共5页
Hebei Medical Journal
基金
甘肃省科技计划项目(编号:20JR10RA755)。
