[1]李小琴,余广兰.急性缺血性脑卒中患者血清Cav-1 和GDF-15 表达水平及对预后的评估价值研究[J].现代检验医学杂志,2022,37(04):118-122+127.[doi:10.3969/j.issn.1671-7414.2022.04.023]
　LI Xiao-qin,YU Guang-lan.Expression Levels of Serum Cav-1 and GDF-15 and Their Prognostic Value in Patients with Acute Ischemic Stroke[J].Journal of Modern Laboratory Medicine,2022,37(04):118-122+127.[doi:10.3969/j.issn.1671-7414.2022.04.023]
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急性缺血性脑卒中患者血清Cav-1 和GDF-15 表达水平及对预后的评估价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年04期
页码:
118-122+127
栏目:
论著
出版日期:
2022-07-15

文章信息/Info

Title:
Expression Levels of Serum Cav-1 and GDF-15 and Their Prognostic Value in Patients with Acute Ischemic Stroke
文章编号:
1671-7414（2022）04-118-06
作者:
李小琴; 余广兰
宜宾市第一人民医院神经内科，四川宜宾 644000
Author(s):
LI Xiao-qin; YU Guang-lan
Department of Neurology, the First People’s Hospital of Yibin, Sichuan Yibin 644000, China
关键词:
急性缺血性脑卒中; 陷窝蛋白-1; 生长分化因子-15
分类号:
R743.3；R392.11
DOI:
10.3969/j.issn.1671-7414.2022.04.023
文献标志码:
A
摘要:
目的 探讨血清陷窝蛋白-1(Caveolin-1, Cav-1) 及生长分化因子-15(growth differentiation factor-15, GDF-15) 水平在急性缺血性脑卒中(acute ischemic stroke, AIS) 中的表达及对预后的预测价值。方法 选取2019 年2 月～ 2021 年6 月宜宾市第一人民医院神经内科收治的156 例AIS 患者作为观察组，根据美国国立卫生研究院卒中量表(the NationalInstitutes of Health Stroke Scale，NIHSS) 评分结果将其分为轻、中、重度组；根据脑梗死面积将其分为腔隙性、中等面积、大面积脑梗死组；根据出院3 个月改良Rankin 量表(mRS) 评分结果将其分为预后良好组和预后不良组。另选取同期进行体检的60 例健康者为对照组。比较各组血清Cav-1 和GDF-15 水平；采用受试者工作特征曲线(ROC) 评估血清Cav-1 和GDF-15 水平对患者预后的预测价值。结果 观察组血清Cav-1(22.78±4.54 ng/ml) 和 GDF-15 (790.90±76.75pg/ml) 水平均高于对照组（8.51±2.52 ng/ml，410.51±37.58 pg/ml），差异有统计学意义(t=22.997，36.699, 均 P＜ 0.05)。重度组、中度组和轻度组血清Cav-1 (26.95±5.08 ng/ml，23.22±2.79 ng/ml 和18.97±3.29ng/ml) 和GDF-15(839.82±96.62pg/ml，806.82±52.01pg/ml 和728.45±54.70pg/ml) 表达水平依次降低，差异均有统计学意义(F=50.667，33.847, 均P ＜ 0.05)。大面积梗死组、中等面积梗死组和腔隙性梗死组血清Cav-1 (26.91±4.67ng/ml，22.66±2.98 ng/ml 和18.95±3.15ng/ml) 和GDF-15(847.38±84.92pg/ml，800.64±46.49pg/ml 和717.99±54.56 pg/ml) 表达水平依次降低，差异均有统计学意义(F=51.550，48.155, 均P ＜ 0.05)。预后不良组血清Cav-1(25.88±3.69 ng/ml) 和GDF-15(828.52±74.32 pg/ml) 水平均高于对照组（20.62±3.77 ng/ml，764.74±67.25pg/ml），差异有统计学意义(t=8.658，5.579,均P ＜ 0.05)。Pearson 相关分析显示，AIS 患者血清Cav-1 和GDF-15 水平与NIHSS 评分、脑梗死面积和mRS 评分呈正相关(r=0.496 ～ 0.715, 均P ＜ 0.05)；ROC 曲线表明，血清Cav-1，GDF-15 和血清Cav-1+GDF-15 预测AIS 患者预后的曲线下面积(AUC) 为0.847，0.785 和0.910，血清Cav-1+GDF-15 的AUC 高于血清Cav-1 和GDF-15(Z=5.396，7.853,均P ＜ 0.05)，血清Cav-1+GDF-15 预测AIS 预后的敏感度和特异度分别为87.6% 和80.1%。结论 AIS 患者血清Cav-1和GDF-15 水平升高，并与病情严重程度及预后密切相关，两者联合检测可作为评估病情及预测预后的重要指标。
Abstract:
Objective To investigate the expression of serum Caveolin-1(Cav-1) and growth differentiation factor-15 (GDF-15) in acute ischemic stroke (AIS) and its prognostic value. Methods 156 patients with AIS in the First People’s Hospital of Yibin were selected as the observation group.According to the National Institutes of Health Stroke Scale (NIHSS), they were divided into mild, moderate and severe groups. According to the area of cerebral infarction, they were divided into lacunar, medium and large area cerebral infarction groups. According to the modified Rankin Scale (MRS) score of three months after discharge, they were divided into good prognosis group and poor prognosis group. Another 60 healthy persons who underwent physical examination at the same time were selected as the control group. The levels of serum Cav-1 and GDF-15 were compared. Receiver operating characteristic curve (ROC) was used to evaluate the prognostic value of serum Cav-1 and GDF-15 levels. Results The levels of serum Cav-1 (22.78±4.54 ng/ml) and GDF-15 (790.90±76.75 pg/ml) in the observation group were higher than those in the control group（8.51±2.52 ng/ml，410.51±37.58 pg/ml）, the differences were statistically significant(t=22.997，36.699, all P ＜ 0.05).There were significant differences in serum Cav-1 (26.95±5.08 ng/ml，23.22±2.79 ng/ml, 18.97±3.29ng/ml) and GDF-15 (839.82±96.62pg/ml, 806.82±52.01pg/ml, 728.45±54.70pg/ml) decreased successively between severe group, moderate group and mild group the difference were statistically significant(F=50.667， 33.847, all P ＜ 0.05). There were significant differences in serum Cav-1(26.91±4.67ng/ml, 22.66±2.98 ng/ml, 18.95±3.15ng/ ml) and GDF-15(847.38±84.92pg/ml, 800.64±46.49pg/ml，717.99±54.56 pg/ml) decreased successively between large area infarction group, medium area infarction group and lacunar infarction group, the differences were statistically significant(F=51.550，48.155, all P ＜ 0.05).The levels of serum Cav-1(25.88±3.69 ng/ml) and GDF-15 (828.52±74.32 pg/ml) in the poor prognosis group were higher than those in the good prognosis group(20.62±3.77 ng/ml, 764.74±67.25pg/ml), the differences were statistically significant(t=8.658 ,5.579, all P ＜ 0.05). Pearson correlation analysis showed that the levels of serum Cav-1 and GDF-15 in patients with AIS were positively correlated with NIHSS score, cerebral infarction area and mRS score (r=0.496 ～ 0.715, all P ＜ 0.05). The ROC curve showed that the area under the curve (AUC) of serum Cav-1, GDF-15 and serum Cav-1+GDF-15 in predicting the prognosis of AIS patients were 0.847, 0.785 and 0.910. The AUC of serum Cav- 1+GDF-15 was higher than that of serum Cav-1 and GDF-15 (z=5.396, 7.853, all P ＜ 0.05). The sensitivity and specificity of serum Cav-1 + GDF-15 were 87.6% and 80.1%, respectively. Conclusion The levels of serum Cav-1 and GDF-15 in patients with AIs are increased, which were closely related to the severity and prognosis. The combined detection of them can be used as an important index to evaluate the condition and predict the prognosis.

参考文献/References:

[1] 喻长莉, 李建军. 急性缺血性脑卒中患者血清TIGAR mRNA 水平及其与预后的关系[J]. 中国动脉硬化杂志, 2020, 28(7):589-593. YU Changli, LI Jianjun. Serum TIGAR mRNA level in patients with acute ischemic stroke and its relationship with prognosis [J]. Chinese Journal of Arteriosclerosis,2020,28(7):589-593.
[2] 韩光. 外周血血小板参数对评估急性脑梗死患者生活能力改善的临床价值[J]. 现代检验医学杂志,2020, 35(2): 119-123. HAN Guang. Clinical value of platelet parameters in evaluating the improvement of life ability in patients with acute cerebral infarction [J]. Journal of Modern Laboratory Medicine, 2020,35(2):119-123.
[3] 黄一伟. 血清irisin 在急性缺血性脑卒中患者预后评估中的临床价值[J]. 中国全科医学, 2019, 22(S1):85-88. HUANG Yiwei. Clinical prognostic value of serum irisin in patients with acute ischemic stroke [J]. Chinese General Practice,2019,22(S1):85-88.
[4] 钟义良, 张融融, 黄思源, 等. 急性脑梗死患者血清陷窝蛋白1 水平与早期神经功能恶化的关系[J]. 上海交通大学学报( 医学版), 2017, 37(12): 1678-1681. ZHONG Yiliang, ZHANG Rongrong, HUANG Siyuan, et al. Relationship between serum level of caveolin-1 and early neurological deterioration in patients with acute cerebral infarction [J]. Journal of Shanghai Jiaotong University(Medical Science),2017,37(12):1678-1681.
[5] 许丽丽, 曹辉, 张尧, 等. 陷窝蛋白-1 参与白蛋白改善蛛网膜下腔出血后血脑屏障通透性[J]. 国际脑血管病杂志, 2018, 26(3): 195-200. XU Lili, CAO Hui, ZHANG Rao, et al. Caveolin-1 involvement of albumin in improving blood-brain barrier permeability after subarachnoid hemorrhage[J]. International Journal of Cerebrovascular Diseases,2018,26(3):195-200.
[6] 岳海楠, 董晓宇, 仙剑非. 生长分化因子-15 与急性脑梗死关系的研究进展[J]. 卒中与神经疾病, 2017,24(3): 258-261. YUE Hainan, DONG Xiaoyu, XIAN Jianfei.Research progress on the relationship between growth differentiation factor-15 and acute cerebral infarction[J].Stroke and Nervous Diseases, 2017, 24(3): 258-261.
[7] 国家卫生健康委员会急诊医学质控中心, 中国医师协会急诊医师分会, 世界中医药学会联合会急症专业委员会．中国急性缺血性脑卒中急诊诊治专家共识[J]．中国急救医学, 2018, 38（4）：281-287． National Health Commission Emergency Medical Quality Control Center, Chinese Medical Doctor Association Emergency Medical Branch, World Federation of Chinese Medicine Societies Emergency Professional Committee. Expert consensus on emergency diagnosis and treatment of acute ischemic stroke in China [J].Chinese Journal of Critical Care Medicine, 2018, 38(4): 281-287.
[8] 张丽冉, 李艳华, 夏瑞雪, 等．急性脑梗死患者血清OPN, NLRP3 水平与神经损伤和预后的关系[J]. 脑与神经疾病杂志, 2021, 29(8): 502-506. ZHANG Liran, LIYanhua, XIA Ruixue, et al.Relationship between serum OPN and NLRP3 levels and nerve injury and prognosis in patients with acute cerebral infarction [J]. Journal of Brain and Nervous Diseases, 2021,29(8):502-506.
[9] XIE Dewei, XIANG Weiwei, WENG Yiyun, et al.Platelet volume indices for the prognosis of acute ischemic stroke patients with intravenous thrombolysis[J].International Journal of Neuroscience, 2019, 129(4):344-349.
[10] 张勇, 田仲兰, 何改平. 血清CXCL12 和IL-33 在急性缺血性脑卒中预后评估中的价值[J]. 中国免疫学杂志, 2017, 33(10):1540-1543. ZHANG Yong, TIAN Zhonglan, HE Gaiping. Prognostic value of serum CXCL12 and IL-33 levels in patients with acute ischemic stroke [J]. Chinese Journal of Immunology,2017,33(10):1540-1543.
[11] KUO A, LEE M Y, YANG K, et al. Caveolin-1 regulates lipid droplet metabolism in endothelial cells via autocrine prostacyclin-stimulated, cAMP-mediated lipolysis[J]. J Biol Chem, 2018, 293(3):973-983.
[12] MIERKE J, CHRISTOPH M, AUGSTEIN A, et al. Influence of Caveolin-1 and endothelial nitric oxide synthase on adventitial inflammation in aortic transplantsitle[J]. Kardiologia polska, 2019, 78(2):124-130.
[13] 杜开先, 李曼曼, 张华玲, 等. 细菌性脑膜炎及病毒性脑炎患儿脑脊液陷窝蛋白-1、基质金属蛋白酶-9及白细胞介素-1β 的变化 [J] . 中华实用儿科临床杂志,2019,34 (10): 749-752. DU Kaixian, LI Manman, ZHANG Hualing, et al.Changes of Caveolin-1, matrix metalloproteinase-9 and interleukin-1β in cerebrospinal fluid of children with bacterial meningitis or viral encephalitis [J].Chinese Journal of Applied Clinical Pediatrics,2019,34(10):749-752.
[14] ZHAO Yun , PANG Qiongyi , LIU Meixia , et al.Treadmill exercise promotes neurogenesis in ischemic rat brains via caveolin-1/VEGF signaling pathways[J].Neurochemical Research, 2017, 42(2):389-397.
[15] 黄素芬, 易健, 刘柏炎. 陷窝蛋白-1 与脑缺血后炎性反应[J]. 国际脑血管病杂志, 2016,24(3) :259-262. HUANG Sufen, YI Jian, LIU Baiyan. Caveolin-1 and inflammation after cerebral ischemia [J]. International Journal of Cerebrovascular Diseases, 2016,24(3) :259-262.
[16] 王晋雁, 焦丽萍, 郝丽莎, 等．血清Cav-1,YKL-40在急性脑梗死中的表达及其联合检测对预后的评估价值[J]. 中国医师杂志, 2021, 23(2): 231-235. WANG Jinyan, JIAO Liping, HAO Lisha, et al.Expression of serum Cav-1 and YKL-40 in acute cerebral infarction and the value of combined detection in prognosis evaluation [J]. Journal of Chinese Physician, 2021,23(2) :231-235.
[17] HIJAZI Z, OLDGREN J, ANDERSSON U, et al.Growth-differentiation factor 15 and risk of major bleeding in atrial fibrillation: Insights from the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial[J]. The American Heart Journal,2017, 190(1): 94-103.
[18] 刘冬冬, 梅岩艾. 生长分化因子-15 在神经系统、心血管疾病以及癌症进程中的作用[J]. 生理学报,2017, 69(1):109-121. LIU Dongdong, MEI Yanai. Effects of growth differentiation factor-15(GDF-15) on neurological systems,cardiovascular diseases, and cancer progression [J].Acta Physiologica Sinica, 2017,69(1):109-121.
[19] 杨纪粉, 卢婷婷, 纪向虹, 等. 生长分化因子15 的临床应用研究进展[J]. 医学综述, 2018, 24(23):4625-4629. YANG Jifen, LU Tingting, JI Xianghong, et al.Research progress in clinical application of growth differentiation factor-15 [J]. Medical Recapitulate,2018,24(23):4625-4629.
[20] 王小雯. 血清骨桥蛋白、神经胶质纤维酸性蛋白及生长分化因子15 水平在急性脑梗死患者神经损伤及预后评估中的应用价值[J]. 新乡医学院学报,2019,36(5):479-482. WANG Xiaowen. Application value of serum osteopontin, neurofibrillar acidic protein and growth differentiation factor 15 in the assessment of nerve injury and prognosis in patients with acute cerebral infarction [J]. Journal of Xinxiang Medical University,2019,36(5):479-482.
[21] 张茜, 张波, 朱武. 老年急性脑梗死患者血清脂蛋白a、生长分化因子15 及D-二聚体水平变化及其诊断价值研究[J]. 实用心脑肺血管病杂志,2019,27(8):56-61,67. ZHANG Qian, ZHANG Bo, ZHU Wu. Changes of serum levels of Lp(a),GDF-15 and D-dimer and their diagnostic value in elderly patients with acute cerebral infarction [J]. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 2019, 27(8):56-61,67.
[22] 崔伟, 李爱华, 孟宪举, 等. 中老年多发性脑梗死合并肺炎患者血小板参数及炎症指标分析[J]. 中华医院感染学杂志,2019,29(14):2121-2124. CUI Wei, LI Aihua, MENG Xianju, et al. Value of platelet parameters and inflammatory factors in diagnosis of pneumonia in middle-aged and elderly patients with multiple cerebral infarction [J]. Chinese Journal of Nosocomiology, 2019,29(14):2121-2124.
[23] 尹克金, 栾丽芹, 王文斌, 等. 低血清陷窝蛋白-1 预测急性缺血性卒中患者的转归不良[J]. 国际脑血管病杂志,2016,24(8):699-703. YIN Kejin, LUAN Liqin, WANG Wenbin, et al. Low caveolin-1 predicts the poor outcome in patients with acute ischemic stroke [J].International Journal of Cerebrovascular Diseases,2016,24(8):699-703.
[24] 周静, 罗勇, 姚珊, 等. 急性缺血性脑卒中患者血清HCY, GDF-15, GFAP 水平与神经功能及预后的关系[J]. 山东医药,2017,57(18):46-48. ZHOU Jing,LUO Yong,YAO Shan,et al.Relationship between serum Hcy,GDF-15,GFAP levels and neurological function and prognosis in patients with acute ischemic stroke[J].Shandong Medical Journal,2017, 57(18): 46-48.

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[8]刘 懿,贺晓婵,王亚荣,等.急性缺血性脑卒中患者血清AIM2 和LTB4 水平表达及与预后的相关性研究[J].现代检验医学杂志,2023,38(04):22.[doi:10.3969/j.issn.1671-7414.2023.04.004]
　LIU Yi,HE Xiaochan,WANG Yarong,et al.Study on the Expression Levels of Serum AIM2 and LTB4 in Patients with Acute Ischemic Stroke and Their Correlation with Prognosis[J].Journal of Modern Laboratory Medicine,2023,38(04):22.[doi:10.3969/j.issn.1671-7414.2023.04.004]
[9]郭继勃a,钟 曌b,郭 昊c,等.急性缺血性脑卒中患者血浆LIPCAR 和MMP-9 水平与病情严重程度及溶栓治疗后认知功能的关系研究[J].现代检验医学杂志,2023,38(05):40.[doi:10.3969/j.issn.1671-7414.2023.05.008]
　GUO Jiboa,ZHONG Zhaob,GUO Haoc,et al.Study on the Relationship between Peripheral Blood LIPCAR, MMP-9 and Severity of Acute Ischemic Stroke and Cognitive Function after RT-PA Intravenous Thrombolysis[J].Journal of Modern Laboratory Medicine,2023,38(04):40.[doi:10.3969/j.issn.1671-7414.2023.05.008]
[10]郝 瑜a,刘 超b,曹银光a,等.大血管闭塞型急性缺血性脑卒中患者血清PTX3 水平与机械取栓首次通过效应及预后的相关性研究[J].现代检验医学杂志,2024,39(04):110.[doi:10.3969/j.issn.1671-7414.2024.04.020]
　HAO Yua,LIU Chaob,CAO Yinguanga,et al.Association of Serum PTX3 Level with First-pass Effect and Prognosis of Mechanical Thrombectomy in Patients with Acute Ischemic Stroke of Large Vessel Occlusion[J].Journal of Modern Laboratory Medicine,2024,39(04):110.[doi:10.3969/j.issn.1671-7414.2024.04.020]

备注/Memo

备注/Memo:
基金项目：宜兵市卫生健康委员会科研项目（2019352-25）。
作者简介：李小琴(1987-)，女，硕士研究生，主治医师，研究方向：缺血性脑血管疾病，E-mail:wjljt11@163.com。
通讯作者：余广兰，副主任医师，E-mail:mingyangwsj8853@sina.com。
更新日期/Last Update: 1900-01-01