鸢尾素水平与急性脑梗死患者溶栓治疗短期预后相关

姚丽娜.鸢尾素水平与急性脑梗死患者溶栓治疗短期预后相关[J].内科急危重症杂志,2023,29(4):298-300

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DOI：10.11768/nkjwzzzz20230409

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基金项目:河北省2018年度医学科学研究重点课题计划（No：20181496）

作者	单位	E-mail
姚丽娜	保定市第二中心医院	myce49582@sina.cn

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中文摘要:

摘要目的：探讨鸢尾素达水平对急性脑梗死（ACI）患者溶栓治疗短期预后的评估价值。方法：选取ACI患者95例，均给予静脉注射尿激酶进行溶栓治疗，于溶栓90d后采用改良版Rankin量表（mRS）评分评估疗效，并根据其评分进行分组，0~1分为预后良好组，2~6分为预后不良组。应用酶联免疫吸附法（ELISA）测定所有患者血清鸢尾素水平，分析其与mRS评分的相关性；采用Logistics多因素回归分析影响ACI预后的因素；绘制受试者工作特征（ROC）曲线，评价鸢尾素对ACI患者短期预后的评估价值。结果：预后良好组纳入46例ACI患者，预后不良组纳入49例；溶栓前预后良好组血清鸢尾素浓度显著高于预后不良组（ P <0.05）；Pearson相关分析显示，血清鸢尾素水平与mRS评分呈低度负相关（ r=-0.245，P =0.017）；单因素分析显示，鸢尾素、年龄、冠心病、心房颤动、国立卫生研究院卒中量表（NIHSS）评分及溶栓治疗间隔时间对ACI预后具有显著影响（ P 均≤0.05）；Logistics回归显示，鸢尾素（ OR =2.316，95% CI ：1.166~4.600）、溶栓治疗间隔时间（ OR =3.353，95% CI ：1.097~10.249）、年龄（ OR=2.270，95%CI ：1.017~5.071）及NIHSS评分（ OR=2.075，95%CI： 1.025~4.202）是影响ACI患者预后的独立危险因素；鸢尾素为250.6 ng/L时，ROC曲线下面积为0.868，灵敏度为74.3%，特异性为83.5%。结论：鸢尾素可作为急性ACI溶栓治疗后90d预后的评估指标。

英文摘要:

Abstract Objective: Evaluate the value of Irisin as prognosis biomarker in short-term survival of patients with acute cerebral infarction (ACI) after thrombolytic therapy. Methods: A total of 97 patients with ACI in our hospital from June 2017 to December 2019 were selected and all patients were treated with intravenous urokinase. The therapeutic effect was evaluated by modified Rankin scale (mRS) after 90 days of thrombolysis. The enzyme-linked immunosorbent assay was used to detect and compare the serum Irisin levels of all patients. The correlation between the expression of Irisin and mRS score was analyzed. Univariate analysis was used to investigate the prognostic factors of ACI. Logistics analysis was carried out on the key factors affecting ACI, and the main risk factors were found. By drawing the receiver operating characteristic (ROC) curve of Irisin to the 90-day prognosis, the prognostic value of Irisin was further evaluated. Results: A total of 46 patients with ACI and 49 patients with ACI were enrolled in the good prognosis group and the poor prognosis group, respectively. The serum Irisin in the good prognosis group (305.45±31.24) ng/L was significantly higher than (233.37±26.70) ng/L in the poor prognosis group (P<0.05). Pearson correlation showed that serum Irisin level was negatively correlated with mRS score (r =-0.245, P= 0.017). Univariate analysis showed that Irisin, age, coronary heart disease, atrial fibrillation, National Institutes of Health Stroke Scale (NIHSS) score and thrombolytic therapy interval had a significant impact on the prognosis of ACI (P< 0.05). Logistics regression analysis showed that Irisin (OR=2.316, 95%CI 1.166-4.600), thrombolytic therapy interval (OR=3.353, 95%CI 1.097-10.249), age (OR=2.270, 95%CI 1.017-5.071) and NIHSS score (OR=2.075, 95%CI 1.025-4.202) were the independent risk factors for the prognosis of ACI patients. The ROC curve of Irisin in predicting the prognosis of ACI was drawn, the area under ROC curve of Irisin was 0.868, the sensitivity was 74.3%, and the specificity was 83.5%. Conclusion: Irisin can be used as a prognostic marker for 90 days after acute ACI thrombolytic therapy.