[1]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):110-115.[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):110-115.[doi:10.3969/j.issn.1671-7414.2024.04.020]
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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()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年04期
页码:
110-115
栏目:
论著
出版日期:
2024-07-15

文章信息/Info

Title:
Association of Serum PTX3 Level with First-pass Effect and Prognosis of Mechanical Thrombectomy in Patients with Acute Ischemic Stroke of Large Vessel Occlusion
文章编号:
1671-7414（2024）04-110-06
作者:
郝 瑜a; 刘 超b; 曹银光a; 李长云a
（聊城市人民医院a. 检验科；b. 神经外科，山东聊城 252000）
Author(s):
HAO Yua; LIU Chaob; CAO Yinguanga; LI Changyuna
(a.Department of Clinical Laboratory；b.Department of Neurosurgery，Liaocheng People’s Hospital，Shandong Liaocheng 252000, China)
关键词:
急性缺血性脑卒中; 正五聚蛋白3; 机械取栓; 首次通过效应
分类号:
R743.3；R392.11
DOI:
10.3969/j.issn.1671-7414.2024.04.020
文献标志码:
A
摘要:
目的 探讨正五聚蛋白3（pentraxin 3，PTX3）与大血管闭塞型急性缺血性脑卒中（acute ischemic stroke，AIS）患者机械取栓首次通过效应的关系。方法 选取2023 年1 ～ 8 月在聊城市人民医院进行治疗的大血管闭塞型AIS 患者136 例，进行机械取栓根据是否获得首次通过效应将其分为首次通过组（n=41）以及未首次通过组（n=95）。收集所有患者的临床资料并检测血清PTX3 的水平。对所有患者进行三个月的随访，根据改良Rankin 评分判定预后情况。采用多因素Logistic 回归法分析大血管闭塞型AIS 患者首次通过效应的影响因素，采用受试者工作特征（ROC）曲线分析血清PTX3 对大血管闭塞型AIS 患者首次通过效应的预测价值。结果 首次通过组的预后情况良好率高于未首次通过组（56.10% vs 36.84%），差异具有统计学意义（χ2=4.341，P=0.037）。与未首次通过组相比，首次通过组的年龄（59.38±5.12 岁）、高血压比例（43.90%）、入院美国国立卫生研究院卒中量表（national institute ofhealth stroke scale，NIHSS）评分（13.58±4.16 分）以及血清PTX3 水平（1.21±0.32 ng/L）均低于未首次通过组（63.45±7.61 岁，65.26%，15.75±5.13 分，1.71±0.41ng/L），差异具有统计学意义（t/χ2=3.129，5.395，2.389，6.944，均P<0.05）。经多因素Logistic 回归法分析显示，年龄较小[OR(95%CI)：0.859（0.752 ～ 0.982)]、无高血压[OR(95%CI)：0.672（0.480 ～ 0.942）]、入院NIHSS 评分下降[OR(95%CI) ：0.867（0.781 ～ 0.962）] 以及血清PTX3 水平下降[OR(95%CI)：0.558（0.326 ～ 0.954）] 均是大血管闭塞型AIS 患者机械取栓首次通过效应的影响因素（Waldχ2 值=4.997，5.238，7.280，4.543，均P<0.05）。经过三个月随访，预后良好组的血清PTX3 水平低于预后不良组（1.28±0.39 ng/L vs 1.65±0.43 ng/L），差异具有统计学意义（t=5.111，P<0.001）。经ROC 分析显示，血清PTX3 对大血管闭塞型AIS 患者首次通过效应和不良预后的预测价值较高，曲线下面积（95%CI）分别为0.785（0.703 ～ 0.866）和0.734（0.651 ～ 0.806），最佳临界值分别为1.38 ng/L 和1.56 ng/L。结论 大血管闭塞型AIS患者机械取栓获得首次通过效应利于短期预后，血清PTX3 的表达情况与大血管闭塞型AIS 患者首次通过效应密切相关，且该指标对患者能否获得首次通过效应有较高的预测价值。
Abstract:
Objective To investigate the relationship between pentraxin 3 (PTX3) and first-pass effect of mechanical thrombectomy in patients with large vessel occlusion acute ischemic stroke (AIS). Methods A total of 136 AIS patients with large vessel occlusion treated in Liaocheng People’s Hospital from January to August 2023 were selected, and they were divided into first pass group (n=41) and non-first pass group (n=95) according to whether they achieved first-pass effect of mechanical thrombectomy. The clinical data of all patients were collected and the serum PTX3 levels were detected. All patients were followed up for 3 months, and the prognosis was evaluated according to the modified Rankin score. Multivariate Logistic regression was used to analyze the influencing factors of first-pass effect in AIS patients with large vessel occlusion. ROC analysis was used to analyze the predictive value of serum PTX3 for first-pass effect in AIS patients with large vessel occlusion. Results The rate of good prognosis in the first pass group was higher than that in the non-first pass group (56.10% vs 36.84%),and the difference was significant (χ2=4.341, P=0.037). Compared with the non-first pass group, the age (59.38±5.12 years), the proportion of hypertension (43.90%), the National Institutes of Health Stroke Scale (NIHSS) score at admission (13.58±4.16 score) in the first pass group and serum PTX3 level (1.21±0.32 ng/L) in the first pass group were lower than those in the failed group (63.45±7.61 years, 65.26%，15.75±5.13 score,1.71±0.41 ng/L), and the differences were significant (t/χ2=3.129, 5.395, 2.389, 6.944, all P<0.05). Multivariate Logistic regression analysis showed that younger age [OR(95%CI): 0.859 (0.752 ～ 0.982)], no hypertension [OR(95%CI): 0.672 (0.480 ～ 0.942)], decreased NIHSS score at admission [OR(95%CI): 0.867 (0.781 ～ 0.962)] and decreased serum PTX3 levels [OR(95%CI): 0.558 (0.326 ～ 0.954)] were the influencing factors of the first-pass effect of mechanical thrombectomy in AIS patients with large vessel occlusion (Waldχ2 =4.997, 5.238, 7.280, 4.543, all P<0.05). After 3 months of follow-up, the serum PTX3 level of the good prognosis group was lower than that of the poor prognosis group (1.28±0.39 ng/L vs 1.65±0.43 ng/L), and the difference was significant (t=5.111, P<0.001). ROC analysis showed that serum PTX3 had a high predictive value for first-pass effect and poor prognosis in AIS patients with large vessel occlusion, with the areas under the curve (95%CI) of 0.785 (0.703 ～ 0.866) and 0.734 (0.651 ～ 0.806), respectively, and their optimal cut-off values were 1.38 ng/L and 1.56 ng/L, respectively. Conclusion The first-pass effect of mechanical thrombectomy in AIS patients with large vessel occlusion is beneficial to the short-term prognosis. The expression of serum PTX3 is closely related to the first-pass effect in AIS patients with large vessel occlusion, and this index could have a high predictive value for whether the patients can achieve the first-pass effect.

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备注/Memo

备注/Memo:
基金项目：山东省科技厅自然科学基金面上项目（编号ZR2017MH099）。
作者简介：郝瑜（1982-），女，本科，副主任技师，研究方向：临床检验及诊断，E-mail：13963515816@163.com。
通讯作者：李长云（1984-），女，本科，副主任技师，研究方向：临床医学检验，E-mail：lichangyun123456@126.com。
更新日期/Last Update: 2024-07-15