摘要
目的探讨急性脑梗死(Acute cerebral infarction,ACI)患者静脉溶栓前后血清内皮素-1(Endothelin-1,ET-1)、基质细胞衍生因子-1(Stromal cell derived factor 1,SDF-1)水平变化,分析ET-1、SDF-1与功能结局的关系。方法选取2021年2月-2023年2月大兴区人民医院收治的103例ACI患者。根据日常生活能力(Activity of daily living,ADL)量表将其分为功能结局良好组及功能结局不良组。检测患者溶栓前后血清ET-1和SDF-1水平。Logistic回归模型分析ACI功能结局的影响因素,Pearson相关性分析血清ET-1、SDF-1水平与ADL评分的相关性,根据受试者工作特征(Receiver operating characteristics,ROC)曲线分析血清ET-1、SDF-1水平对ACI功能结局的预测价值。结果ACI患者溶栓1周后血清ET-1水平降低,SDF-1水平升高(P<0.05);ACI患者功能结局不良发生率为39.81%;与功能结局良好组比较,功能结局不良组发病至溶栓时间、NIHSS评分、合并心房室颤占比、溶栓前、溶栓1周后血清ET-1水平升高,SDF-1水平降低(P<0.05);Logistic回归分析结果显示,发病至溶栓时间长、NIHSS评分高、溶栓1周后的血清ET-1高水平及SDF-1低水平是ACI功能结局不良的独立危险因素(P<0.05);Pearson相关性分析显示,ADL评分与溶栓1周后的血清ET-1水平呈正相关(r=0.563,P<0.05),与SDF-1呈负相关(r=-0.483,P<0.05);ROC分析结果显示,溶栓1周后的血清ET-1、SDF-1二者联合预测ACI功能结局的AUC高于各项单独检测(P<0.05)。结论ACI患者溶栓后血清ET-1水平降低,SDF-1水平升高,溶栓1周后血清ET-1、SDF-1水平与ADL评分均呈正相关,且对于预测ACI功能结局有较高的参考价值。
Objective To investigate the changes of serum endothelin-1(ET-1)and stromal cell derived factor-1(SDF-1)levels before and after intravenous thrombolysis in patients with acute cerebral infarction(ACI),and to analyze the relationship between ET-1 and SDF-1 and functional outcomes.Methods A total of 103 ACI patients admitted to the hospital from February 2021 to February 2023 were selected.The patients were divided into good functional outcome group and poor functional outcome group according to ADL.Serum ET-1 and SDF-1 levels were detected before and after thrombolysis.The influencing factors of ACI functional outcome were analyzed by Logistic regression model,and the correlation between serum ET-1,SDF-1 and ADL score was analyzed by Pearson correlation.The predictive value of serum ET-1 and SDF-1 levels to ACI functional outcome was analyzed according to receiver operating characteristic(ROC)curve.Results After 1 week of thrombolysis in ACI patients,serum ET-1 level was decreased and SDF-1 level was increased(P<0.05).The incidence of adverse functional outcomes in ACI patients was 39.81%.Compared with the good functional outcome group,the time from onset to thrombolysis,NIHSS score,proportion of atrial ventricular fibrillation,serum ET-1 level before thrombolysis and 1 week after thrombolysis in the poor functional outcome group were increased,and the level of SDF-1 was decreased(P<0.05).Logistic regression analysis showed that long time from onset to thrombolysis,high NIHSS score,high serum ET-1 level and low SDF-1 level after 1 week of thrombolysis were independent risk factors for poor ACI functional outcomes(P<0.05).Pearson correlation analysis showed that ADL score was positively correlated with serum ET-1 level after 1 week of thrombolysis(r=0.563,P<0.05),and negatively correlated with SDF-1(r=-0.483,P<0.05).ROC analysis results showed that the AUC of serum ET-1 and SDF-1 combined to predict ACI functional outcome after 1 week of thrombolysis was higher than that of each single test(P<0.05).Conclusion Serum ET-1 level was decreased,and SDF-1 level was increased in ACI patients after thrombolysis.Serum ET-1 and SDF-1 levels were positively correlated with ADL score 1 week after thrombolysis,which had high reference value for predicting ACI functional outcome.
作者
郑丽
陈鸿丽
刘丹
魏彦娟
ZHENG Li;CHEN Hongli;LIU Dan;WEI Yanjuan(Department of Emergency Medicine,Daxing District People's Hospital,Beijing 102600,China;Department of Neurology,Beijing Children's Hospital,Capital Medical University,Beijing 100000,China)
出处
《新疆医科大学学报》
CAS
2024年第2期227-232,共6页
Journal of Xinjiang Medical University
基金
北京市卫生发展科研专项项目(首发2020-1-20382)。
关键词
急性脑梗死
静脉溶栓
血清内皮素-1
基质细胞衍生因子-1
功能结局
acute cerebral infarction
intravenous thrombolysis
serum endothelin-1(ET-1)
stromal cell derived factor-1(SDF-1)
functional outcome
