摘要
目的分析老年急性脑梗死患者血清可溶性OX40配体(sOX40L)、血小板反应蛋白解整合素金属肽酶-4(ADAMTS-4)联合检测对患者预后的预测价值。方法选取2019年7月-2023年8月就诊于河北省保定市第一中心医院的老年急性脑梗死患者作为脑梗组(n=121),并根据预后mRS评分分为预后良好组(n=78)和预后不良组(n=43),根据不同脑损伤程度分为轻度(n=31)、中度(n=57)和重度损伤组(n=33),另选取体检健康者作为健康组(n=68)。用酶联免疫吸附法检测血清sOX40L、ADAMTS-4水平并进行比较;收集患者临床资料并分析;用受试者工作特征(ROC)曲线评估血清sOX40L、ADAMTS-4水平对老年急性脑梗死患者预后的预测价值;logistic回归分析影响老年急性脑梗死患者预后的因素。结果脑梗组血清sOX40L、ADAMTS-4水平高于健康组,差异均有统计学意义(t=13.946、14.297,P均<0.05);且血清sOX40L、ADAMTS-4水平随着脑损伤程度的加重而升高,差异均有统计学意义(F=31.900、22.080,P均<0.05)。预后不良组血清sOX40L、ADAMTS-4水平高于预后良好组,差异均有统计学意义(t=10.240、9.433,P均<0.05),两组患者的脑梗死部位、入院时NIHSS评分、Hcy水平差异均有统计学意义(t=5.178、8.818、6.121,P均<0.05)。后循环脑梗死、NIHSS高评分、Hcy、sOX40L、ADAMTS-4水平升高均是老年急性脑梗死患者预后不良的危险因素(P均<0.05)。sOX40L、ADAMTS-4、两者联合预测老年急性脑梗死患者预后的曲线下面积(AUC)分别为0.872、0.879、0.952,联合预测价值更高(Z_(联合vs.sOX40L)=2.794,P=0.005;Z_(联合vs.ADAMTS-4)=2.340,P=0.019)。结论老年急性脑梗死患者血清sOX40L、ADAMTS-4水平显著升高,两者水平变化可能成为预测急性脑梗死预后的指标,且两者联合预测价值更高。
Objective To analyze the prognostic value of the combination of serum soluble OX40 ligand(sOX40L) and A disintegrin and metalloproteinase with thrombospondin motifs-4(ADAMTS-4) in elderly patients with acute cerebral infarction. Methods Elderly patients with acute cerebral infarction who visited in the Baoding First Central Hospital from July 2019 to August 2023 were selected as the cerebral infarction group(n=121), and were separated into a good prognosis group(n=78) and a poor prognosis group(n=43) based on the prognosis mRS score. According to the degree of brain injury, it was divided into mild(n=31), moderate(n=57) and severe injury groups(n=33). Additionally, healthy individuals who underwent physical examination were regarded as the healthy group(n=68). Enzyme linked immunosorbent assay(ELISA) was applied to detect and compare serum levels of sOX40L and ADAMTS-4. Clinical data of patients were collected and analyzed. Receiver operating characteristic(ROC) curve was applied to evaluate the predictive value of serum sOX40L and ADAMTS-4 levels for the prognosis of elderly patients with acute cerebral infarction. Logistic regression was applied to analyze the factors affecting the prognosis of elderly patients with acute cerebral infarction. Results The serum levels of sOX40L and ADAMTS-4 in the cerebral infarction group were greatly higher than those in the healthy group, all the differences were statistically significant(t=13.946, 14.297;all P<0.05), and the serum levels of sOX40L and ADAMTS-4increased with the severity of brain injury;all the differences were statistically significant(F=31.900, 22.080;all P<0.05).The serum levels of sOX40L and ADAMTS-4 in the poor prognosis group were greatly higher than those in the good prognosis group;all the differences were statistically significant(t=10.240, 9.433;all P<0.05). The location of cerebral infarction, NIHSS score at admission, and Hcy level were greatly different between the two groups;all the differences were statistically significant(t=5.178, 8.818, 6.12
作者
刘宁
付燕
张婷
朱晓娟
LIU Ning;FU Yan;ZHANG Ting;ZHU Xiaojuan(Department of Geriatrics,Baoding First Central Hospital,Baoding,Hebei 071000,China;Department of Ophthalmology,Baoding First Central Hospital,Baoding,Hebei 071000,China)
出处
《热带医学杂志》
CAS
2024年第5期721-725,F0003,共6页
Journal of Tropical Medicine
基金
河北省自然科学基金资助项目(H2021104002)。
