[1]刘 静,康 丽,于 艳,等.急性缺血性卒中患者血清ATF3、α2δ-1水平表达与病情评估的价值研究[J].现代检验医学杂志,2026,41(02):146-153.[doi:10.3969/j.issn.1671-7414.2026.02.025]
　LIU Jing,KANG Li,YU Yan,et al.Value of Serum ATF3 and α2δ-1 Levels in Patients with Acute Ischemic Stroke for Disease Assessment[J].Journal of Modern Laboratory Medicine,2026,41(02):146-153.[doi:10.3969/j.issn.1671-7414.2026.02.025]
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急性缺血性卒中患者血清ATF3、α2δ-1水平表达与病情评估的价值研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第41卷
期数:
2026年02期
页码:
146-153
栏目:
论著
出版日期:
2026-03-15

文章信息/Info

Title:
Value of Serum ATF3 and α2δ-1 Levels in Patients with Acute Ischemic Stroke for Disease Assessment
文章编号:
1671-7414（2026）02-146-09
作者:
刘 静a，康 丽b，于 艳a，白丽丽a，郝 华a，李 红a
中国人民解放军总医院 a.第二医学中心健康医学科；b.第一医学中心神经内科，北京 100039
Author(s):
LIU Jinga, KANG Lib, YU Yana, BAI Lilia, HAO Huaa, LI Honga
a. Department of Health Medicine, Second Medical Center; b. Department of Neurology, First Medical Center, Chinese PLA General Hospital, Beijing 100039, China
关键词:
急性缺血性卒中; 激活转录因子3; α2δ-1
分类号:
R743.3；R446.11
DOI:
10.3969/j.issn.1671-7414.2026.02.025
文献标志码:
A
摘要:
目的探讨急性缺血性卒中(AIS)患者血清激活转录因子3(ATF3)、α2δ-1水平表达与病情评估的价值。方法选取2021年1月~2024年8月解放军总医院收治的150例AIS患者为AIS组,根据美国国立卫生研究院卒中量表(NIHSS)评分分为重度组(≥21分,n=45)、中度组(5~20分,n=53)和轻度组(≤4分,n=52);根据脑梗死面积分为大面积组(≥20cm3,n=48)、中等面积组(1cm3~20cm3,n=56)和小面积组(≤1cm3,n=46),另按照1∶1选取同期健康体检志愿者150例为对照组。采用酶联免疫吸附法(ELISA)检测血清ATF3、α2δ-1水平、通过Spearman秩相关分析AIS患者血清ATF3、α2δ-1水平与NIHSS评分和脑梗死面积的相关性,Logistic回归分析AIS患者神经功能缺损程度加重和脑梗死面积增加的影响因素,受试者操作特征(ROC)曲线分析血清ATF3、α2δ-1水平对AIS患者重度神经功能缺损和大面积脑梗死的评估价值。结果与对照组比较,AIS组血清ATF3(4.27±1.39ng/mlvs1.78±0.21ng/ml)、α2δ-1[833.14(385.68,1437.12)pg/mlvs233.59(124.84,337.75)pg/ml]水平升高,差异具有统计学意义(t/Z=21.647、-10.871,均P<0.05)。轻度组、中度组、重度组血清ATF3(3.21±1.12ng/ml、4.35±0.90ng/ml、5.41±1.22ng/ml)、α2δ-1[283.58(202.14,759.77)pg/ml、1004.61(490.07,1403.49)pg/ml、1408.79(914.88,2106.76)pg/ml)]水平依次升高,差异具有统计学意义(F=100.168,J-T=-7.563,均P<0.05)。小面积组、中等面积组、大面积组血清ATF3(3.10±1.09ng/ml、4.32±0.93ng/ml、5.34±1.22ng/ml),α2δ-1[283.58(211.26,584.93)pg/ml、1000.39(493.62,1505.81)pg/ml、1313.92(874.91,2071.12)pg/ml)]水平依次升高,差异具有统计学意义(F=101.166,J-T=-7.610,均P<0.05)。AIS患者血清ATF3、α2δ-1水平与NIHSS评分和脑梗死面积呈正相关(r=0.751~0.764,均P<0.05)。脑梗死面积增加、ATF3和α2δ-1高水平为AIS患者神经功能缺损程度加重的独立危险因素(Waldχ2=34.456、26.025、28.947,均P<0.05),NIHSS评分增加、ATF3和α2δ-1高水平为AIS患者脑梗死面积增加的独立危险因素(Waldχ2=33.095、9.489、25.099,均P<0.05)。血清ATF3、α2δ-1联合评估AIS患者重度神经功能缺损的曲线下面积为0.926,大于血清ATF3、α2δ-1单独评估的0.823、0.812(Z=3.403、3.517),血清ATF3、α2δ-1联合评估AIS患者大面积脑梗死的曲线下面积为0.912,大于血清ATF3、α2δ-1单独评估的0.813、0.802(Z=3.335、3.507),差异具有统计学意义(均P<0.05)。结论AIS患者血清ATF3、α2δ-1水平升高,与神经功能缺损程度加重和脑梗死面积增加有关,可能成为AIS患者病情评估的新的标志物。
Abstract:
Objective To investigate the levels of activating transcription factor 3 (ATF3) and α2δ-1 in serum samples of pa-tients with acute ischemic stroke (AIS) and assess their value for disease assessment. Methods A total of 150 patients with AIS admitted to Chinese PLA General Hospital from January 2021 to August 2024 were enrolled in the AIS group. According to the National Institutes of Health Stroke Scale (NIHSS) score, they were divided into severe group (≥ 21 points, n=45), moderate group (5 ~ 20 points, n=53), and mild group (≤ 4 points, n=52), according to the area of cerebral infarction, patients were divid-ed into large area group (≥ 20 cm3, n=48), medium area group (1 cm3 ~ 20 cm3, n=56), and small area group (≤ 1 cm3, n=46). In addition, a control group of 150 healthy volunteers undergoing routine physical examinations during the same period was selected in a 1:1 ratio. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum ATF3 and α2δ-1 levels. Spearman’s rank correlation was used to analyze the correlation between serum ATF3 and α2δ-1 levels and NIHSS scores or cerebral infarction area in AIS patients. Logistic regression analysis was used to analyze factors influencing aggravation of neuro-logical deficits and increase of cerebral infarction area in AIS patients. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of serum ATF3 and α2δ-1 levels for evaluating severe neurological deficits and massive cerebral infarction in AIS patients. Results Compared with the control group, the serum ATF3 [4.27±1.39 ng/ml vs 1.78±0.21 ng/ml] and α2δ-1 [833.14 (385.68, 1 437.12) pg/ml vs 233.59 (124.84, 337.75) pg/ml] levels in the AIS group increased (t=21.647, Z=-10.871, all P< 0.05). The levels of serum ATF3 in mild, moderate and severe groups were 3.21±1.12 ng/ml, 4.35±0.90 ng/ml, and 5.41±1.22ng/ml, respectively; α2δ-1 levels were 283.58 (202.14, 759.77) pg/ml, 1 004.61 (490.07, 1 403.49) pg/ml, 1 408.79 (914.88, 2 106.76) pg/ml. Both increased progressively with disease severity, showing statistically significant differences (F=100.168, J-T=-7.563, all P< 0.05). The levels of serum ATF3 in small area, medium area and large area groups were 3.10±1.09 ng/ml, 4.32±0.93 ng/ml and 5.34±1.22 ng/ml, respectively; α2δ-1 levels were 283.58 (211.26, 584.93) pg/ml, 1 000.39 (493.62, 1 505.81) pg/ml and 1 313.92 (874.91, 2 071.12) pg/ml, respectively. Both increased progressively with lesion size, the differences were statistically significant (F=101.166, J-T=-7.610, all P< 0.05). The levels of serum ATF3 and α2δ-1 in AIS patients were positively correlated with NIHSS score and cerebral infarction area (r=0.751~0.764, all P< 0.05). Increased cerebral infarction area, elevated ATF3 , and high α2δ-1 were independent risk factors for the aggravation of neurological defi-cit in AIS patients (Wald χ2=34.456, 26.025, 28.947, all P< 0.05). Increased NIHSS score and ATF3, α2δ-1 were independent risk factors for increased cerebral infarction area in AIS patients (Wald χ2=33.095, 9.489, 25.099, all P< 0.05). The area under the curve (AUC) for combined serum ATF3 and α2δ-1 assessment of severe neurological deficits in AIS patients was 0.926, ex-ceeding the AUCs of serum ATF3 (0.823) and α2δ-1 (0.812) alone (Z=3.403, 3.517), the AUC for combined serum ATF3 and α2δ-1 in evaluating extensive cerebral infarction in AIS patients was 0.912, which was greater than the AUCs of 0.813 and 0.802 for serum ATF3 and α2δ-1 alone, respectively (Z=3.335, 3.507), the differences were statistically significant all P< 0.05). Conclusions The increase of serum ATF3 and α2δ-1 levels in AIS patients is related to the aggravation of neurological deficit and the increase of cerebral infarction area, potentially serving as novel biomarkers for disease assessment in AIS patients.

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备注/Memo

备注/Memo:
基金项目：首都卫生发展科研专项项目（2020-3-6010）。
作者简介：刘静（1982-），女，博士研究生，主治医师，研究方向：头痛、脑血管病、健康管理，E-mail：liujing19820427@163.com。
通讯作者：李红（1968-），女，博士研究生，主任医师，研究方向：功能医学、健康管理、肠道菌群，E-mail：scarletthong301@163. com。
更新日期/Last Update: 2026-03-15