摘要
目的探究急性缺血性脑卒中(acute ischemic stroke,AIS)患者外周血Yes相关蛋白(yes-associated protein,YAP)水平与卒中预后影响因素及卒中后炎症指标的相关性。方法纳入2018年11月至2019年5月首都医科大学宣武医院收治的AIS患者,检测患者接受治疗前血浆中YAP和炎性指标的表达水平,收集患者临床资料和3个月预后数据。根据患者3个月改良Rankin量表(modified Rankin Scale,mRS)评分将患者分为预后良好组(mRS≤2,n=92)和预后不良组(mRS>2,n=67),采用多因素Logistic回归分析筛选出与卒中预后相关的独立影响因素,并进一步使用Spearman相关性分析和偏相关分析探究YAP与卒中预后影响因素及卒中后炎症指标之间的关系。结果与转归良好组相比,转归不良组的白细胞计数、中性粒细胞计数、中性粒细胞-淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)显著增高,淋巴细胞计数显著降低(P<0.05)。Logistic回归结果表明较高的年龄(OR=1.04,P=0.013)、糖尿病(OR=3.87,P=0.004)、较高的入院美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分(OR=1.36,P<0.001)是预后的危险因素。相关性分析显示血浆YAP水平与淋巴细胞计数(r=0.22,P=0.006)、白细胞介素(interleukin,IL)-1β(r=0.418,P<0.001)、IL-2(r=0.310,P<0.001)、IL-5(r=0.417,P<0.001)和IL-10(r=0.189,P=0.017)呈正相关关系,而与中性粒细胞计数(r=-0.17,P=0.027)、NLR(r=-0.24,P=0.002)、IL-2R(r=-0.259,P<0.001)、IL-16(r=-0.334,P<0.001)和肝细胞生长因子(hepatocyte growth factor,HGF)(r=-0.317,P<0.001)呈负相关。偏相关分析显示,YAP蛋白水平与IL-2、IL-16、HGF之间的相关性不受其他变量的影响(P<0.05)。结论血浆YAP水平与多种炎性指标存在显著相关关系,提示YAP可能参与了卒中后炎性反应的调控。
Objective This study aims to investigate the relationship of peripheral yes-associated protein(YAP)level in patients with acute ischemic stroke(AIS)with prognostic influencing factors and inflammatory indicators.Methods AIS patients admitted to Xuanwu Hospital of Capital Medical University from November 2018 to May 2019 were enrolled in this study.Expression levels of YAP and inflammatory markers in plasma were detected,and the clinical data and 3-month prognostic data of the patients were collected by experienced neurologists.According to the 3-month modified Rankin Scale(mRS)score,the patients were divided into good outcome group(mRS≤2,n=92)and poor outcome group(mRS>2,n=67).Multivariate Logistic regression analysis was used to identify independent risk factors related to AIS prognosis.Furthermore,Spearman correlation analysis and partial correlation analysis were conducted to explore the relationship of YAP concentration with these prognostic influencing factors and inflammatory indicators.Results Compared with the good outcome group,the poor outcome group exhibited significantly higher white blood cell counts,neutrophil counts,and neutrophil-lymphocyte ratios(NLR),along with significantly lower lymphocyte counts(P<0.05).Logistic regression results indicated that older age(OR=1.04,P=0.013),diabetes mellitus(OR=3.87,P=0.004),and higher admission National Institutes of Health Stroke Scale(NIHSS)scores(OR=1.36,P<0.001)are risk factors for prognosis.Correlation analysis showed that plasma YAP levels were positively correlated with lymphocyte counts(r=0.22,P=0.006),IL-1β(r=0.418,P<0.001),IL-2(r=0.310,P<0.001),IL-5(r=0.417,P<0.001),and IL-10(r=0.189,P=0.017),while being negatively correlated with neutrophil counts(r=-0.17,P=0.027),NLR(r=-0.24,P=0.002),IL-2R(r=-0.259,P<0.001),IL-16(r=-0.334,P<0.001),and(hepatocyte growth factor,HGF)(r=-0.317,P<0.001).Partial correlation analysis indicated that the correlation between YAP protein levels and IL-2,IL-16,and HGF was not affected by other variables(P<0.05).Conclusions
作者
沈童
李芳芳
范俊芬
罗玉敏
Shen Tong;Li Fangfang;Fan Junfen;Luo Yumin(Institute of Cerebrovascular Diseases Research and Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Beijing Geriatric Medical Research Center,Beijing 100053,China)
出处
《首都医科大学学报》
CAS
北大核心
2024年第6期1071-1078,共8页
Journal of Capital Medical University
基金
国家自然科学基金面上项目(82371306)。
关键词
缺血性卒中
Yes相关蛋白
炎症因子
acute ischemic stroke
yes-associated protein
inflammatory marker
