摘要
目的探讨缺血性脑卒中(CIS)患者血清组织蛋白酶S(CatS)、胱抑素C(CysC)的表达水平及临床意义。方法收集2016年3月至2019年3月北京市大兴区人民医院收治的107例CIS患者为病例组,按照颈部血管超声结果将其分为无斑块组(n=27)、稳定性斑块组(n=41)、不稳定性斑块组(n=39);按照美国国立卫生研究院卒中量表(NIHSS)评分将其分为低分组(NIHSS评分<4分,n=36)、中分组(NIHSS评分4-15分,n=45)、高分组(NIHSS评分>15分,n=26);按照改良Rankin量表(MRS)评分将患者随访3个月时的预后分为预后良好组(n=63)和预后不良组(n=44);同期随机选取60例健康体检者为对照组。采用酶联免疫吸附法检测血清CatS水平,全自动生化分析仪检测血清CysC水平。结果病例组血清CatS水平高于对照组,血清CysC水平低于对照组(P<0.05)。随着斑块稳定性变差,血清CatS逐渐升高,血清CysC逐渐下降(P<0.05)。随着NIHSS评分升高,血清CatS逐渐升高,CysC逐渐降低(P<0.05)。预后不良组血清CatS水平高于预后良好组,血清CysC水平低于预后良好组(P<0.05)。经Pearson积矩相关分析,病例组患者血清CatS与IMT、NIHSS评分、MRS评分呈正相关性(r=0.762、0.791、0.708,P<0.05),血清CysC与上述指标呈负相关性(r=-0.776、-0.823、0.763,P<0.05)。血清CatS、CysC预测缺血性脑卒中患者随访3个月预后均有一定价值,AUC分别为0.880、0.838,联合检测的预测价值更高,AUC为0.922。结论血清CatS、CysC异常改变可能介导了CIS患者斑块形成及进展,并且与患者病情严重性及预后密切相关。
Objective To explore the changes and clinical significance of cathepsin S(CatS)and cystatin C(CysC)in patients with cerebral ischemic stroke(CIS).Methods A total of 107 patients with CIS admitted to our hospital from March 2016 to March 2019 were collected as case group,who were divided into non-plaque group(n=27),stable plaque group(n=41)and unstable plaque group(n=39)according to the results of cervical vascular ultrasound.The patients were divided into low score group(NIHSS score<4 points,n=36),middle score group(NIHSS score 4-15 points,n=45)and high score group(NIHSS score>15 points,n=26)according to the National Institutes of Health Stroke Scale(NIHSS).The patients with prognosis at 3 months of follow-up were divided into good prognosis group(n=63)and poor prognosis group(n=44)according to the Modified Rankin Scale(MRS)score.At the same time,60 healthy volunteers were randomly selected as control group.Serum CatS level was detected by the enzyme linked immunosorbent assay and CysC level was detected by the automatic biochemical analyzer.Results The serum CatS level in case group was higher than that in control group,and the serum CysC level was lower than that in control group(P<0.05).With the deterioration of plaque stability,serum CatS increased and serum CysC decreased(P<0.05).With the increase of NIHSS score,serum CatS increased and CysC decreased(P<0.05).The serum CatS in poor prognosis group was higher than that in good prognosis group,and the serum CysC in poor prognosis group was lower than that in good prognosis group(P<0.05).The Pearson product moment correlation analysis showed that serum CatS in the case group was positively associated with IMT,NIHSS score,MRS score(r=0.762,0.791,0.708;P<0.05),serum CysC was negatively associated with the above indexes(r=-0.776,-0.823,-0.763;P<0.05).Serum CatS and CysC have certain value in predicting the prognosis of patients with CIS after follow-up for 3 months,the AUC is 0.880 and 0.838 respectively.The predictive value of both CatS and CysC detection is higher,the AUC is 0.922.Conclusion Abnormal changes of serum CatS and CysC may mediate plaque formation and progression in patients with CIS,which also are closely related to severity and prognosis of disease.
作者
刘立斌
吴妍
李影
王培蕊
王丽娟
Liu Libin;Wu Yan;Li Ying;Wang Peirui;Wang Lijuan(Department of Neurology,the Beijing Daxing District People's Hospital,Beijing 100000,China)
出处
《脑与神经疾病杂志》
2020年第6期374-378,共5页
Journal of Brain and Nervous Diseases
