摘要
目的探讨急性缺血性脑卒中(AIS)患者血清CBL原癌基因样1(CBLL1)、基质金属蛋白酶3(MMP3)水平与静脉溶栓后出血转化(HT)及预后的关联性。方法招募2020年1月至2022年12月于黑龙江省第三医院接受静脉溶栓治疗的AIS患者264例,根据静脉溶栓后HT发生情况将其分为HT组(42例)和非HT组(222例)。比较两组临床资料、治疗前血清CBLL1、MMP3水平及治疗后3个月的预后情况。采用多因素logistic回归分析AIS患者静脉溶栓后发生HT的影响因素。采用受试者工作特征(ROC)曲线分析血清CBLL1、MMP3水平预测AIS患者静脉溶栓后HT发生及预后情况的效能。结果与非HT组相比,HT组美国国立卫生研究院卒中量表(NIHSS)评分、血清CBLL1、MMP3水平以及预后不良[改良Rankin量表(mRS)评分≥3分]发生率更高,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,较高的NIHSS评分[OR(95%CI)=1.298(1.028~1.639)]以及血清CBLL1[OR(95%CI)=1.320(1.023~1.704)]、MMP3[OR(95%CI)=1.406(1.103~1.793)]水平是促进AIS患者静脉溶栓后发生HT的独立危险因素(P<0.05)。ROC曲线分析结果显示,血清CBLL1、MMP3水平联合检测可有效预测AIS患者静脉溶栓后HT发生[AUC(95%CI)=0.936(0.892~0.965),P<0.001]及预后情况[AUC(95%CI)=0.941(0.901~0.985),P<0.001]。结论AIS患者血清CBLL1、MMP3水平升高与静脉溶栓后HT发生及预后不良有关,有助于临床医师识别高危患者,及早干预。
Objective To explore the relationship of serum CBL proto-oncogene like 1(CBLL1)and matrix metalloproteinase 3(MMP3)levels with hemorrhagic transformation(HT)and prognosis after intravenous thrombolysis in acute ischemic stroke(AIS)patients.Methods A total of 264 AIS patients who received intravenous thrombolytic therapy in Third Hospital of Heilongjiang Province from January 2020 to December 2022 were recruited.According to the occurrence of HT after intravenous thrombolysis,the patients were divided into HT group(42 cases)and non-HT group(222 cases).The clinical data,the levels of serum CBLL1 and MMP3 before treatment and the prognosis 3 months after treatment were compared between the two groups.Multivariate logistic regression was used to analyze the influencing factors of HT occurrence after intravenous thrombolysis in the AIS patients.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum CBLL1 and MMP3 levels in predicting the occurrence and prognosis of HT after intravenous thrombolysis in the AIS patients.Results Compared with those in the non-HT group,the National Institutes of Health Stroke Scale(NIHSS)scores,serum CBLL1 and MMP3 levels,and the incidence of adverse prognosis[modified Rankin Scale(mRS)≥3 points]in the HT group were high,and the differences were statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that relatively high NIHSS scores[OR(95%CI)=1.298(1.028-1.639)]and serum CBLL1[OR(95%CI)=1.320(1.023-1.704)]and MMP3[OR(95%CI)=1.406(1.103-1.793)]levels were independent risk factors for occurrence of HT after intravenous thrombolysis in the AIS patients(P<0.05).The results of ROC curve analysis showed that the combined detection of serum CBLL1 and MMP3 levels could effectively predict the occurrence of HT after intravenous thrombolysis[AUC(95%CI)=0.936(0.892-0.965),P<0.001]and the prognosis[AUC(95%CI)=0.941(0.901-0.985),P<0.001]in the AIS patients.Conclusion The elevated serum CBLL1 and MMP3 levels in AIS patients are
作者
穆晓春
靳洪文
佘碧霞
MU Xiaochun;JIN Hongwen;SHE Bixia(Department of Neurology,Third Hospital of Heilongjiang Province,Heihe 164000,China;Department of Neurology,the Beian Hospital of Beidahuang Group,Heilongjiang 164000,China)
出处
《中国临床新医学》
2024年第10期1136-1140,共5页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金
黑龙江省卫生健康委科研课题(编号:2019-103)。
关键词
急性缺血性脑卒中
CBL原癌基因样1
基质金属蛋白酶3
静脉溶栓
出血转化
预后
Acute ischemic stroke(AIS)
CBL proto-oncogene like 1(CBLL1)
Matrix metalloproteinase 3(MMP3)
Intravenous thrombolysis
Hemorrhagic transformation(HT)
Prognosis
