摘要
目的探讨血清间隙连接蛋白43(Cx43)、半乳糖凝集素-9(Gal-9)水平对老年急性脑梗死(ACI)患者超早期静脉溶栓治疗预后的评估价值。方法选取2020年9月至2022年9月在该院行超早期静脉溶栓治疗的106例老年ACI患者作为研究组,另外选取同期来该院体检的100例体检健康者作为健康组。采用酶联免疫吸附试验(ELISA)检测所有研究对象的血清Cx43、Gal-9水平。治疗2周后参考美国国立卫生院卒中量表(NIHSS)评分将106例老年ACI患者分为预后良好组(81例)与预后不良组(25例)。采用受试者工作特征(ROC)曲线分析血清Cx43、Gal-9水平对老年ACI患者超早期静脉溶栓治疗预后的评估价值,采用多因素Logistic回归分析探讨老年ACI患者超早期静脉溶栓治疗预后不良的影响因素。结果研究组血清Cx43、Gal-9水平高于健康组(P<0.05);预后不良组血清Cx43、Gal-9水平高于预后良好组(P<0.05);血清Cx43、Gal-9预测老年ACI患者预后不良的曲线下面积(AUC)分别为0.721(95%CI:0.673~0.758)、0.837(95%CI:0.787~0.886),二者联合预测的AUC为0.901(95%CI:0.857~0.946)。预后不良组高血压占比高于预后良好组(P<0.05);多因素Logistic回归分析显示,高血压(OR=3.487,95%CI:1.564~7.773),血清Cx43≥106.53 pg/mL(OR=4.586,95%CI:1.982~10.611),血清Gal-9≥11.84 ng/mL(OR=4.345,95%CI:1.957~9.648)是老年ACI患者超早期静脉溶栓治疗预后不良的危险因素(P<0.05)。结论血清Cx43、Gal-9在老年ACI患者中均呈高表达,可用于评估老年ACI患者超早期静脉溶栓治疗的预后,二者联合检测的评估价值更高。
Objective To explore the prognostic value of serum gap connexin 43(Cx43)and galectin-9(Gal-9)levels in elderly patients with acute cerebral infarction(ACI)after ultra-early intravenous thrombolytic therapy.Methods A total of 106 elderly patients with ACI who received ultra-early intravenous thrombolytic therapy in the hospital from September 2020 to September 2022 were selected as the study group,and 100 healthy subjects who came to the hospital for physical examination during the same period were selected as the health group.The levels of Cx43 and Gal-9 in serum of all subjects were detected by enzyme-linked immunosorbent assay(ELISA).After 2 weeks of treatment,106 elderly ACI patients were divided into good prognosis group(81 cases)and poor prognosis group(25 cases)according to the National Institutes of Health Stroke Scale(NIHSS)score.Receiver operating characteristic(ROC)curve was used to analyze the evaluation value of serum Cx43 and Gal-9 in the prognosis of ultra-early intravenous thrombolytic therapy in elderly ACI patients.Multivariate Logistic regression analysis was used to explore the influencing factors of poor prognosis of ultra-early intravenous thrombolytic therapy in elderly ACI patients.Results The levels of Cx43 and Gal-9 in the study group were higher than those in the health group(P<0.05).The levels of Cx43 and Gal-9 in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The area under the curve(AUC)of serum Cx43 and Gal-9 for predicting the poor prognosis in elderly ACI patients was 0.721(95%CI:0.673-0.758)and 0.837(95%CI:0.787-0.886),respectively,and the AUC of combined detection of CX43 and GAL-9 was 0.901(95%CI:0.857-0.946).The proportion of hypertension in the poor prognosis group was higher than that in the good prognosis group(P<0.05).Hypertension(OR=3.487,95%CI:1.564-7.773),serum Cx43≥106.53 pg/mL(OR=4.586,95%CI:1.982-10.611),serum Gal-9≥11.84 ng/mL(OR=4.345,95%CI:1.957-9.648)were risk factors for poor prognosis in elderly patients with ACI after ultra-early intravenous thrombolysis(P<0.05).Conclusion Serum Cx43 and Gal-9 are highly expressed in elderly ACI patients,which could be used to evaluate the prognosis of elderly ACI patients after ultra-early intravenous thrombolysis therapy,and their combined detection has higher evaluation value.
作者
蒋召芹
穆永芳
刘宇鹏
聂亚冬
JIANG Zhaoqin;MU Yongfang;LIU Yupeng;NIE Yadong(Department of Emergency,Qinhuangdao First Hospital,Qinhuangdao,Hebei 066000,China)
出处
《国际检验医学杂志》
CAS
2024年第14期1715-1719,共5页
International Journal of Laboratory Medicine
基金
河北省科学技术厅项目(172777202)。
