摘要
目的分析血清甘露糖结合凝集素相关丝氨酸蛋白酶3(MASP-3)、甘露聚糖结合凝集素(MBL)及对称二甲基精氨酸(SDMA)对老年急性缺血性脑卒中(AIS)的诊断价值。方法选取2019年1月—2020年12月华润辽健集团阜新矿总医院神经内科收治的老年AIS患者86例为AIS组,另选取老年体检健康者50例为健康对照组。酶联免疫吸附法检测血清一氧化氮(NO)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、MASP-3、MBL、SDMA水平。Pearson相关性分析老年AIS患者血清MASP-3、MBL、SDMA水平与血清NO、IL-6、TNF-α水平的相关性。多因素Logistic回归分析血清MASP-3、MBL、SDMA水平与老年AIS的关系。ROC曲线分析血清MASP-3、MBL、SDMA水平对老年AIS的诊断价值。结果与健康对照组比较,AIS组血清MASP-3、MBL、NO水平降低(t/P=6.368/<0.001、5.587/<0.001、7.884/<0.001),SDMA、IL-6、TNF-α水平显著升高(t/P=6.857/<0.001、8.161/<0.001、6.823/<0.001)。老年AIS患者血清MASP-3、MBL水平与IL-6、TNF-α水平均呈负相关,与NO水平均呈正相关(P均<0.01);SDMA与NO水平呈负相关,与IL-6、TNF-α水平呈正相关(P均<0.01)。血清MASP-3、MBL升高是老年AIS发生的独立保护因素[OR(95%CI)=0.977(0.957~0.997)、0.830(0.697~0.989)],SDMA升高是老年AIS发生的独立危险因素[OR(95%CI)=2.052(1.412~2.984)]。血清MASP-3、MBL、SDMA及三者联合诊断老年AIS的AUC为0.790、0.796、0.792、0.911,三者联合诊断老年AIS的曲线下面积大于血清MASP-3、MBL、SDMA单独诊断(Z/P=3.543/<0.001、2.709/0.007、3.921/<0.001)。结论老年AIS患者血清MASP-3、MBL水平降低,为老年AIS发生的独立保护因素;SDMA水平升高,为老年AIS发生的独立危险因素,可作为老年AIS诊断的生物学标志物。
Objective To analyze the diagnostic value of serum mannose-binding lectin-associated serine protease 3(MASP-3),mannan-binding lectin(MBL)and symmetric dimethylarginine(SDMA)in elderly patients with acute ischemic stroke(AIS).Methods A total of 86 elderly patients with AIS who were admitted to the Neurology Department of Fuxin Mine General Hospital of China Resources Liaojian Group from January 2019 to December 2020 were selected as the AIS group,and 50 elderly healthy subjects were selected as the healthy control group.The levels of serum NO,interleukin 6(IL-6),tumor necrosis factorα(TNF-α),MASP-3,MBL and SDMA were detected by enzyme-linked immunosorbent assay.Pearson correlation analysis of the correlation between serum MASP-3,MBL,SDMA levels and serum NO,IL-6,TNF-αlevels in elderly patients with AIS.Multivariate Logistic regression analysis was used to analyze the relationship between serum MASP-3,MBL,SDMA levels and AIS in the elderly.ROC curve analysis of serum MASP-3,MBL,SDMA levels in the diagnosis of elderly AIS.Results Compared with the healthy control group,the serum levels of MASP-3,MBL and NO in the AIS group decreased,while the levels of SDMA,IL-6 and TNF-αincreased(t/P=6.368/<0.001,5.587/<0.001,7.884/<0.001,6.857/<0.001,8.161/<0.001,6.823/<0.001).Serum MASP-3 and MBL levels in elderly patients with AIS were negatively correlated with IL-6 and TNF-αlevels,and positively correlated with NO levels(all P<0.01).SDMA was negatively correlated with NO level,and positively correlated with IL-6 and TNF-αlevels(P<0.01).Increased serum MASP-3 and MBL were independent protective factors for AIS in the elderly[OR(95%CI)=0.977(0.957-0.997),0.830(0.697-0.989)],and elevated SDMA was an independent risk factor for AIS in the elderly[OR(95%CI)=2.052(1.412~2.984)].The areas under the curve of serum MASP-3,MBL,SDMA and their combination in the diagnosis of elderly AIS were 0.790,0.796,0.792,and 0.911.The area under the curve of the three combined diagnosis of elderly AIS was greater than that of serum MASP-3,MBL and SDMA alone(Z/P=3.543/<0.001,2.709/0.007,3.921/<0.001).Conclusion The serum levels of MASP-3 and MBL in elderly patients with AIS decreased,while the level of SDMA increased,which were independent influencing factors of the occurrence of AIS in the elderly and could be used as biological markers for the diagnosis of AIS in the elderly.
作者
衣丽华
董岩
郑丽莎
王佳
Yi Lihua;Dong Yan;Zheng Lisha;Wang Jia(Department of Neurology, Fuxin Mining Group General Hospital of China Resources Liaojian Group, Liaoning Province, Fuxin 123000,China)
出处
《疑难病杂志》
CAS
2022年第5期456-460,474,共6页
Chinese Journal of Difficult and Complicated Cases
基金
辽宁省自然科学基金资助项目(2018014475-027)。
