[1]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):22-26+172.[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):22-26+172.[doi:10.3969/j.issn.1671-7414.2023.04.004]
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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()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年04期
页码:
22-26+172
栏目:
论著
出版日期:
2023-07-15

文章信息/Info

Title:
Study on the Expression Levels of Serum AIM2 and LTB4 in Patients with Acute Ischemic Stroke and Their Correlation with Prognosis
文章编号:
1671-7414（2023）04-022-06
作者:
刘 懿1; 贺晓婵2;  王亚荣3; 苏晓明4a; 王媛媛4a; 孔 维4b; 张 熊4a
（1. 西安交通大学第一附属医院检验科，西安710061；2. 西安交通大学附属红会医院输血科，西安710054；3. 咸阳市泾阳县医院检验科，陕西泾阳713700；4. 咸阳市第一人民医院a. 检验科；b. 神经内科，陕西咸阳712000）
Author(s):
LIU Yi1; HE Xiaochan2;  WANG Yarong3;  SU Xiaoming4a;  WANG Yuanyuan4a;  KONG Wei4b;  ZHANG Xiong4a
（1. Department of Clinical Laboratory, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China; 2.Department of Blood Transfusion, Red Cross Hospital Affiliated to Xi’an Jiaotong University, Xi’an 710054，China; 3.Department of Clinical Laboratory, Jingyang County Hospital of Xianyang City, Shaanxi Jingyang 713700，China; 4a.Department of Clinical Laboratory; 4b. Department of Neurology, the First People’s Hospital of Xianyang City, Shaanxi Xianyang 712000, China）
关键词:
急性缺血性脑卒中; 重组组织型纤溶酶原激活剂（rt-PA）; 黑色素瘤缺乏因子2; 白三烯B4
分类号:
R743.3；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.04.004
文献标志码:
A
摘要:
目的　探讨血清黑色素瘤缺乏因子2（absent in melanoma 2，AIM2）和白三烯B4（leukotriene B4，LTB4）水平与急性缺血性脑卒中（acute ischemic stroke，AIS）患者预后的相关性。方法　收集2020 年2 月～ 2021 年2 月期间于西安交通大学第一附属医院、西安交通大学附属红会医院、咸阳市第一人民医院和泾阳县医院接受组织型纤溶酶原激活剂（tissue plasminogen activator，tPA）进行静脉溶栓治疗的138 例AIS 患者的临床资料进行回顾性分析。收集患者治疗三月后的改良 Rankin 评分量表（modified Rankin rating scale，mRS）评价其神经功能情况。依据mRS 评分将AIS 患者分为预后良好组（mRS 评分≤ 2 分，n=87）和预后不良组（mRS 评分>2 分，n=51）。采用酶联免疫吸附试验检测血清AIM2 和LTB4 水平。收集患者入院时的美国国立卫生研究院卒中患者神经功能缺损(neurological deficits instroke patients at the National Institutes of Health，NIHSS) 评分、梗死体积和侧支循环建立状况等信息。分析血清AIM2和LTB4 水平、入院NIHSS 评分、梗死体积和侧支循环建立状况与AIS 患者预后的相关性。建立多因素Logistic 回归模型分析rt-PA 静脉溶栓后AIS 患者预后不良的危险因素。结果　与预后良好组比较，预后不良组的血清AIM2（1 161.51±338.56pg/ml vs 964.77±171.94pg/ml） 和LTB4 水平（137.99±35.49pg/ml vs 117.85±21.60pg/ml） 明显增高，差异具有统计学意义（t=4.638，4.148，均P<0.01）。Logistic 回归分析发现AIS 患者血清AIM2 和LTB4 水平增高、梗死体积增大、入院 NIHSS 评分增高及侧支循环建立状况较差均为AIS 患者预后不良的独立危险因素（均P<0.05）。相关性分析显示AIS 患者的血清AIM2 和LTB4 水平分别与梗死体积和入院NIHSS 评分呈正相关性(r=0.374，0.334；0.233，0.304，均P<0.05)。AIM2 和LTB4 水平增高患者的侧支循环建立状况较差（均P<0.01）。受试者工作特征（receiveroperating characteristic，ROC）曲线分析显示 AIM2，LTB4 及联合检测诊断AIS 预后不良的曲线下面积（area undercurve，AUC）分别为0.706（95%CI：0.607 ～ 0.806，P=0.000），0.745（95%CI：0.655 ～ 0.835，P=0.000）和0.740（95%CI：0.648 ～ 0.833，P=0.000）；约登系数分别为0.424，0.386 和0.422；敏感度和特异度分别为60.80%，81.60%；62.70%，75.90%；68.60%，75.80%。AIM2 和LTB4 诊断AIS 预后不良的截断值分别为1 065.93pg/ml 和130.68pg/ml。结论　血清AIM2 和LTB4 水平增高可能增加AIS 患者rt-PA 静脉溶栓后预后不良的风险，因此检测患者血清AIM2 和LTB4 水平可以为AIS 患者的预后评估提供依据。
Abstract:
Objective　To investigate the correlation between the serum levels of absent in melanoma 2 (AIM2) and leukotriene B4 (LTB4) and the prognosis of acute ischemic stroke (AIS). Methods　The clinical data of 138 AIS patients who received rt-PA intravenous thrombolytic therapy in the First Affiliated Hospital of Xi’an Jiaotong University, Red Cross Hospital Affiliated to Xi’an Jiaotong University，the First People’s Hospital of Xianyang and Jingyang County Hospital from February 2020 to February 2021 were retrospectively analyzed. According to the modified Rankin Rating Scale (mRS) after 3 months of treatment, the neurological function was divided into good prognosis group (mRS score ≤ 2, n=87) and poor prognosis group (mRS score>2, n=51). Serum AIM2 and LTB4 levels were detected by ELISA and collected the scores of neurological deficits in stroke patients at the National Institutes of Health (NIHSS), infarct volume, collateral circulation establishment and other information. The correlation between the prognosis of AIS and the levels of serum AIM2 and LTB4, NIHSS score, infarct volume and collateral circulation were analyzed. Multivariate logistic regression model was established to analyze the risk factors of poor prognosis of AIS after rt-PA intravenous thrombolysis. Results　Compared with the good prognosis group, the levels of AIM2 (1 161.51±338.56pg/ml vs 964.77±171.94pg/ml) and LIB4(137.99±35.49pg/ml vs 117.85±21.60 pg/ml) in the poor prognosis group were significantly increased, the differences were statistically significant (t=4.638，4.148，all P<0.01). Logistic regression analysis showed that an increase of AIM2 level, LTB4 level, infarction volume, NIHSS score and poor collateral circulation were independent risk factors for poor prognosis in AIS patients (all P<0.05). Correlation analysis showed that serum AIM2 and LTB4 levels in AIS patients were positively correlated with infarct volume and NIHSS score (r=0.374，0.334；0.233， 0.304，all P<0.05). The establishment of collateral circulation in patients with elevated AIM2 and LTB4 levels was significantly worse (all P<0.01). The analysis of ROC curve showed that the area under the curve （AUC）of AIM2, LTB4 and combined detection for poor prognosis of AIS were 0.706 (95% CI: 0.607 ～ 0.806, P=0.000), 0.745 (95% CI: 0.655 ～ 0.835, P=0.000) and 0.740 (95% CI: 0.648 ～ 0.833, P=0.000)，respectively.The Jordan coefficients were 0.424, 0.386 and 0.422, respectively. The sensitivity and specificity were 60.80% and 81.60%, 62.70% and 75.90%, 68.60% and 75.80%, respectively. The cut-off values of AIM2 and LTB4 for poor prognosis of AIS were 1 065.93pg/ml and 130.68pg/ml, respectively. Conclusion　The increase of serum AIM2 and LTB4 levels may increase the risk of poor prognosis in AIS patients after intravenous thrombolysis with rt-PA. Therefore, the detection of serum AIM2 and LTB4 levels can provide a basis for the prognosis evaluation of AIS patients receiving rt-PA intravenous thrombolysis.

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备注/Memo

备注/Memo:
基金项目：陕西省创新能力支撑计划项目（2020PT-007）：PCSK9 功能获得性突变诱导的新型家兔动脉粥样硬化模型建立及其评估。
作者简介：刘懿(1986-)，女，医学学士，主管检验师，研究方向：卒中的实验室诊断，E-mail：3383418063@qq.com。
通讯作者：贺晓婵(1987-)，女，医学学士，主管检验师，研究方向：卒中的实验室诊断，E-mail：3070470043@qq.com。
更新日期/Last Update: 2023-07-15