[1]王 辉,胡玉姣,李鹏飞,等.急性缺血性脑卒中早期患者铁死亡模型评分与临床预后的相关性研究[J].现代检验医学杂志,2026,41(01):132-136.[doi:10.3969/j.issn.1671-7414.2026.01.025]
　WANG Hui,HU Yujiao,LI Pengfei,et al.Correlation between Ferroptosis Model Score and Clinical Prognosis in Early Patients with Acute Ischemic Stroke[J].Journal of Modern Laboratory Medicine,2026,41(01):132-136.[doi:10.3969/j.issn.1671-7414.2026.01.025]
点击复制

急性缺血性脑卒中早期患者铁死亡模型评分与临床预后的相关性研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第41卷
期数:
2026年01期
页码:
132-136
栏目:
论著
出版日期:
2026-01-15

文章信息/Info

Title:
Correlation between Ferroptosis Model Score and Clinical Prognosis in Early Patients with Acute Ischemic Stroke
文章编号:
1671-7414（2026）01-132-05
作者:
王 辉1，胡玉姣1，李鹏飞1，高 南2
1.中国人民解放军联勤保障部队第966医院神经内科，辽宁丹东 118000;2.中国人民解放军32669部队内科，辽宁丹东 118100
Author(s):
WANG Hui1，HU Yujiao1，LI Pengfei1，GAO Nan2
1.Department of Neurology, People’s Liberation Army Support Unit 966th Hospital, Liaoning Dandong 118000, China;2.Department of Internal Medicine, People’s Liberation Army 32669, Liaoning Dandong 118100, China
关键词:
铁死亡模型; 急性缺血性脑卒中; 美国国立卫生研究院卒中量表
分类号:
R743.3；R446.11
DOI:
10.3969/j.issn.1671-7414.2026.01.025
文献标志码:
A
摘要:
目的探讨急性缺血性脑卒中患者早期铁死亡相关蛋白表达与神经功能恶化和预后的潜在联系。方法选取2020年1月~2022年12月中国人民解放军联勤保障部队第966医院收治的190例发病7天内的急性缺血性卒中患者作为研究对象。入院后24h内采集静脉血样，采用ELISA方法检测血浆中神经丝轻链（NfL）、4-羟基-2-壬烯醛（4-HNE）、8-羟基-2’-脱氧鸟苷（8-oxo-dG）和铁蛋白（Ft）的水平，通过公式计算铁死亡模型评分：-100×NfL+20×4-HNE+17×8-oxo-dG+170×Ft。以卒中发作后3个月的改良Rankin评分（mRS）来评估短期结局，将患者分为预后良好组（mRS≤2，n=136）和预后不良组（mRS≥3，n=54）。比较两组临床特征及铁死亡模型评分的差异，采用Logistic回归分析急性缺血性卒中患者3个月不良结局的影响因素。Spearman相关性分析铁死亡模型评分与美国国立卫生研究院卒中量表（NIHSS）评分的相关性。ROC曲线分析铁死亡模型评分预测急性缺血性卒中患者3个月不良结局的能力。结果与预后良好组相比，预后不良组的4-HNE水平（22.92±4.14ng/mlvs21.06±2.57ng/ml），8-oxo-dG水平（7.00±1.05ng/mlvs6.40±0.75ng/ml）和铁死亡模型评分（109.93±11.01vs90.44±6.67）均显著升高，NfL水平（91.83±5.20ng/mlvs93.65±4.74ng/ml）显著降低，差异具有统计学意义（t=2.328~14.906，均P<0.05）。铁死亡模型评分（OR=1.633，95%CI=1.326~2.011）和白蛋白（Alb）（OR=63.266，95%CI=5.581~717.214）是急性缺血性卒中患者3个月不良结局的独立影响因素。相关性分析显示，铁死亡模型评分与入院时NIHSS评分、出院时NIHSS评分呈正相关（r=0.165、0.178，均P<0.05）。当铁死亡模型评分截断值为95.5时，其预测急性缺血性脑卒中患者3个月不良结局的AUC为0.931，敏感度为90.7%，特异度为75.0%。结论铁死亡模型评分与缺血性脑卒中后不良结局相关，并可用于预测患者的短期预后。
Abstract:
Objective To explore the potential relationship between the expression of ferroptosis-related protein and the deterio-ration of neurological function and functional prognosis after acute ischemic stroke. Methods From January 2020 to December 2022, the study screened 190 patients with acute ischemic stroke, who were admitted to People’s Liberation Army Support Unit 966th Hospital within 7 days after symptoms appeared. Venous blood samples were collected within 24 hours after admission, and the levels of neurofilament light chain (NfL), 4-hydroxy-2-nonenal (4-HNE), 8-hydroxy-2’-deoxyguanosine (8-oxo-dG) and ferritin(Ft) in plasma were evaluated by ELISA kit, and the ferroptosis model score was calculated by the following formula:-100×NfL+20×4-HNE+17×8-oxo-dG+170×Ft. The short-term outcome was evaluated by modified Rankin scale (mRS) of 3 months, and the patients were divided into good prognosis group (mRS≤2, n=136) and poor prognosis group (mRS≥3, n=54). The demographic and clinical characteristics of the two groups were compared. The influencing factors of adverse outcomes of acute ischemic stroke patients for 3 months were analyzed by Logistic regression. Spearman correlation analysis correlation be-tween iron death model score and NIHSS score. ROC curve analysis of iron death model score to predict the 3-month adverse outcome of patients with acute ischemic stroke. Results Compared with the group with good prognosis, the 4-HNE level (22.92±4.14ng/ml vs 21.06±2.57ng/ml), 8-oxo-dG level (7.00±1.05ng/ml vs 6.40±0.75ng/ml) and ferroptosis model score(109.93±11.01 vs 90.44±6.67) in the group with poor prognosis all increased significantly, while NfL level (91.83±5.20ng/ml vs 93.65±4.74ng/ml) decreased significantly, and the differences were statistical significance (t=2.328~14.906, all P<0.05). Fer-roptosis model score (OR=1.633, 95%CI=1.326~2.011) and albumin (OR=63.266, 95%CI=5.581~717.214) were independent in-fluencing factors for the poor outcome of acute ischemic stroke patients in three months. Correlation analysis showed that the fer-roptosis model score was positively correlated with NIHSS score at admission and NIHSS score at discharge (r=0.165, 0.178, all P<0.05). When the cutoff score of the ferroptosis model was 95.5, its AUC for predicting adverse outcomes in acute ischemic stroke patients at 3 months was 0.931, with a sensitivity of 90.7% and a specificity of 75.0%. Conclusions The ferroptosis model score is associated with adverse outcomes after ischemic stroke and can be used to predict the short-term prognosis of patients.

参考文献/References:

[1] PENG S X, LIU X Z, CAO W Z, et al. Global, regional, and national time trends in mortality for stroke, 1990-2019: an age-period-cohort analysis for the global bur-den of disease 2019 study and implications for stroke prevention[J]. International Journal of Cardiology, 2023, 383: 117-131.
[2] TU W J, HUA Y, YAN F, et al. Prevalence of stroke in China, 2013-2019: a population-based study[J]. Lancet Regional Health, 2022, 28: 100550.
[3] JIANG M, SHEN J, MUHAMMAD BLL, et al. Red blood cell distribution width to platelet ratio predicts early neurological deterioration in acute ischemic stroke patients receiving intravenous thrombolysis[J]. Journal of Stroke and Cerebrovascular Diseases, 2023, 32(7): 107146.
[4] SENERS P, BEN HASSEN W, LAPERGUE B, et al. Prediction of early neurological deterioration in indi-viduals with minor stroke and large vessel occlusion intended for intravenous thrombolysis alone[J]. JAMA Neurology, 2021, 78(3): 321-328.
[5] EBINGER M, SIEGERINK B, KUNZ A, et al. Associ-ation between dispatch of mobile stroke units and func-tional outcomes among patients with acute ischemic stroke in berlin[J]. JAMA, 2021, 325(5): 454-466.
[6] YEH S J, CHEN C H, LIN Y H, et al. Association of ferroptosis with severity and outcomes in acute isch-emic stroke patients undergoing endovascular throm-bectomy: a case-control study[J]. Molecular Neurobiol-ogy, 2023, 60(10): 5902-5914.
[7] FAN J X, CHEN M Y, CAO S, et al. Identification of a ferroptosis-related gene pair biomarker with immune infiltration landscapes in ischemic stroke: a bioinfor-matics-based comprehensive study[J]. BMC Genomics, 2022, 23(1): 59.
[8] SIMONSEN S A, WEST A S, HEIBERG A V, et al. Is the TOAST classification suitable for use in personal-ized medicine in ischemic stroke?[J]. Journal of Per-sonalized Medicine, 2022, 12(3): 496.
[9] DEVOS D, MOREAU C, KYHENG M, et al. A ferro-ptosis-based panel of prognostic biomarkers for amy-otrophic lateral sclerosis[J]. Scientific Reports, 2019, 9(1): 2918.
[10] RAYNALD, SUN D P, HUO X C, et al. The safety and efficacy of endovascular treatment in acute ischemic stroke patients caused by large-vessel occlusion with different etiologies of stroke: data from ANGEL-ACT registry[J]. Neurotherapeutics, 2022, 19(2): 501-512.
[11] YANG K L, ZENG L T, YUAN X, et al. The mecha-nism of ferroptosis regulating oxidative stress in isch-emic stroke and the regulation mechanism of natural pharmacological active components[J]. Biomedicine &Pharmacotherapy, 2022, 154: 113611.
[12] LI J, NGUYEN T D, ZHANG Q H, et al. Cerebral mi-crobleeds are associated with increased brain iron and cognitive impairment in patients with cerebral small vessel disease: a quantitative susceptibility mapping study[J]. Journal of Magnetic Resonance Imaging, 2022, 56(3): 904-914.
[13] CHEN J M, YANG L, GENG L X, et al. Inhibition of Acyl-CoA synthetase long-chain family member 4 fa-cilitates neurological recovery after stroke by regulation ferroptosis[J]. Frontiers in Cellular Neuroscience, 2021, 15: 632354.
[14] DENG X M, CHU W M, ZHANG H R, et al. Nrf2 and ferroptosis: a new research direction for ischemic stroke[J]. Cellular and Molecular Neurobiology, 2023, 43(8): 3885-3896.
[15] MCCARTY M F, LERNER A. Nutraceutical induction and mimicry of heme oxygenase activity as a strategy for controlling excitotoxicity in brain trauma and isch-emic stroke: focus on oxidative stress[J]. Expert Re-view of Neurotherapeutics, 2021, 21(2): 157-168.
[16] ZHENG P, WANG X J, CHEN J S, et al. Plasma neu-rofilament light chain predicts mortality and long-term neurological outcomes in patients with intracerebral hem-orrhage[J]. Aging and Disease, 2023, 14(2): 560-571.
[17] SANG L L, TENG W Y, ZHAO M M, et al. Associa-tion between serum ferritin and outcomes in critically ill patients: a retrospective analysis of a large intensive care unit database[J]. Chinese Medical Journal, 2022, 135(21): 2634-2636.
[18] LIU L L, PANG J J, QIN D D, et al. Deubiquitinase OTUD5 as a novel protector against 4-HNE-triggered ferroptosis in myocardial ischemia/reperfusion inju-ry[J]. Advanced Science, 2023, 10(28): e2301852.
[19] LORENTE L, MART?N M M, GONZ?LEZ-RIVERO A F, et al. DNA and RNA oxidative damage are associ-ated to mortality in patients with cerebral infarction[J]. Medicina Intensiva, 2021, 45(1): 35-41.
[20] 苏龙,车海江,林涛,等.脑出血患者血清神经丝轻链水平与病情程度及早期预后的相关性研究[J].现代检验医学杂志,2021,36(4):101-105. SU L, CHE H J, LIN T, et al. Correlation of serum neu-rofilament light chain and severity and early prognosis in patients with acute intracerebral hemorrhage[J]. Journal of Modern Laboratory Medicine, 2021, 36(4): 101-105.

相似文献/References:

[1]国钰梅1,马 龙1,包成月1,等.急性缺血性脑卒中患者尿酸水平与出院结局的关联研究[J].现代检验医学杂志,2015,30(03):17.[doi:10.3969/j.issn.1671-7414.2015.03.005]
　GUO Yu-mei1,MA Long1,BAO Cheng-yue1,et al.Relationship between Uric Acid Levels in Patients with Acute Ischemic Stroke and Discharged Outcome[J].Journal of Modern Laboratory Medicine,2015,30(01):17.[doi:10.3969/j.issn.1671-7414.2015.03.005]
[2]许红霞,宋来春.血栓弹力图动态监测AIS患者瑞通立静脉溶栓过程及其应用[J].现代检验医学杂志,2016,31(05):137.[doi:10.3969/j.issn.1671-7414.2016.05.040]
　XU Hong-xia,SONG Lai-chun.Thromboelastographic Dynamic Monitoring and Clinical Application in Patients Experiencing Acute Ischemic Stroke and Receiving Reteplase[J].Journal of Modern Laboratory Medicine,2016,31(01):137.[doi:10.3969/j.issn.1671-7414.2016.05.040]
[3]郭　洁,池水侠.急性缺血性脑卒中患者血清miRNA-181c-5p，miRNA-340-5p和miRNA146a水平表达检测的诊断价值研究[J].现代检验医学杂志,2021,36(05):43.[doi:10.3969/j.issn.1671-7414.2021.05.009]
　GUO Jie,CHI Shui-xia.Diagnostic Value of miRNA-181c-5p, miRNA-340-5p and miRNA146a Levelsin Patients with Acute Ischemic Stroke[J].Journal of Modern Laboratory Medicine,2021,36(01):43.[doi:10.3969/j.issn.1671-7414.2021.05.009]
[4]张亚杰,王玉琳,董晓娇,等.急性缺血性脑卒中患者血清lncRNASNHG12表达水平检测及临床意义[J].现代检验医学杂志,2022,37(02):121.[doi:10.3969/j.issn.1671-7414.2022.02.025]
　ZHANG Ya-jie,WANG Yu-lin,DONG Xiao-jiao,et al.Detection of Serum lncRNA SNHG12 Expression Level in Patients with Acute Ischemic Stroke and Its Clinical Significance[J].Journal of Modern Laboratory Medicine,2022,37(01):121.[doi:10.3969/j.issn.1671-7414.2022.02.025]
[5]石庆丽,贾嘉琦,李秀艳,等.急性缺血性脑卒中患者血清Hcy，LncRNA CAI2 和ERCC1 表达水平与预测并发认知障碍的价值研究[J].现代检验医学杂志,2022,37(04):53.[doi:10.3969/j.issn.1671-7414.2022.04.011]
　SHI Qing-li,JIA Jia-qi,LI Xiu-yan,et al.Serum Hcy, LncRNA CAI2 and ERCC1 Expression Levels in Patients with Acute Ischemic Stroke and the Value of Predicting Cognitive Impairment[J].Journal of Modern Laboratory Medicine,2022,37(01):53.[doi:10.3969/j.issn.1671-7414.2022.04.011]
[6]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.[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(01):118.[doi:10.3969/j.issn.1671-7414.2022.04.023]
[7]孙丽坤,赵凤依,常玮鑫,等.急性缺血性脑卒中患者血清lncRNA SOX2OT 和miR-331 水平对不稳定斑块形成和重度神经功能缺损的诊断价值[J].现代检验医学杂志,2022,37(06):76.[doi:10.3969/j.issn.1671-7414.2022.06.014]
　SUN Li-kun,ZHAO Feng-yi,CHANG Wei-xin,et al.Diagnostic Value of Serum lncRNA SOX2OT, miR-331 Levels in Patients with Acute Ischemic Stroke for Unstable Plaque Formation and Severe Neurological Deficit[J].Journal of Modern Laboratory Medicine,2022,37(01):76.[doi:10.3969/j.issn.1671-7414.2022.06.014]
[8]刘高雯,段 颖.急性缺血性脑卒中小鼠模型脑组织中miR-21 表达对炎症反应和细胞凋亡的影响及相关机制研究[J].现代检验医学杂志,2023,38(03):86.[doi:10.3969/j.issn.1671-7414.2023.03.015]
　LIU Gao-wen,DUAN Ying.Effects of miR-21 Expression on Inflammatory Response and Apoptosis in Brain Tissue of Mice with Acute Ischemic Stroke and Related Mechanisms[J].Journal of Modern Laboratory Medicine,2023,38(01):86.[doi:10.3969/j.issn.1671-7414.2023.03.015]
[9]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(01):22.[doi:10.3969/j.issn.1671-7414.2023.04.004]
[10]郭继勃,钟 曌,郭 昊,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 Jibo,ZHONG Zhao,GUO Hao,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(01):40.[doi:10.3969/j.issn.1671-7414.2023.05.008]

备注/Memo

备注/Memo:
基金项目：辽宁省临床重点专科项目（2021-A4513774）。
作者简介：王辉（1968-），女，研究生，副主任医师，研究方向：神经内科，E-mail：wuqww9090@163.com。
通讯作者：高南（1987-），女，本科，主治医师，研究方向：全科，E-mail：nengdftohh5155@163.com。
更新日期/Last Update: 2026-01-15