血清S100A8/A9水平对急性缺血性卒中患者rt-PA静脉溶栓后早期神经功能恶化有预测价值

石博.血清S100A8/A9水平对急性缺血性卒中患者rt-PA静脉溶栓后早期神经功能恶化有预测价值[J].内科急危重症杂志,2024,30(6):532-535

DOI：10.11768/nkjwzzzz.20240610

中文关键词: 缺血性卒中 S100钙结合蛋白A8/A9复合物 rt-PA静脉溶栓神经功能恶化

英文关键词:

基金项目:

作者	单位	E-mail
石博	淄博市第一医院	zbdyyysnsb@163.com

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中文摘要:

摘要目的：探讨血清S100钙结合蛋白A8/A9复合物（S100A8/A9）水平与急性缺血性卒中（AIS）患者重组人组织型纤溶酶原激活物（rt-PA）静脉溶栓后早期神经功能恶化（END）的关系。方法：选取180例接受rt-PA静脉溶栓的AIS患者为研究对象，根据是否发生END分为END组（37例）和非END组（143例）。采用酶联免疫吸附法（ELISA）检测血清S100A8/A9水平，分析发生END的影响因素；采用受试者工作特征（ROC）曲线分析S100A8/A9对END发生的预测价值。结果：有心房颤动史、高血压史的AIS患者更易发生END。与非END组比较，END组发病至溶栓时间更长、美国国立卫生研究院卒中量表（NIHSS）评分及血清S100A8/A9水平更高（P均＜0.05）。ROC曲线分析显示，血清S100A8/A9预测AIS患者rt-PA静脉溶栓后发生END的曲线下面积为0.791（0.692~0.891），最佳截断值为1.807mg/mL时，敏感度为78.4%，特异性为79.0%；心房颤动史、高血压史、NIHSS评分、S100A8/A9是发生END的影响因素（P均＜0.05）。结论：S100A8/A9可作为判断AIS静脉溶栓后是否发生END的辅助指标。

英文摘要:

Abstract Objective: To investigate the relationship between serum S100 calbindin A8/A9 complex (S100A8/A9) level and early neurological deterioration (END) in patients with acute ischemic stroke (AIS) after intravenous thrombolysis with recombinant human tissue plasminogen activator (rt-PA). Methods: A total of 180 AIS patients who received rt-PA intravenous thrombolysis were selected as the research objects and categorized into 37 in the END group and 143 in the non-END group. Serum S100A8/A9 levels were assayed using enzyme-linked immunosorbent assay (ELISA) and factors influencing the occurrence of END were analyzed. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of S100A8/A9 for the occurrence of END. Results: Patients with AIS with a history of atrial fibrillation and hypertension were more likely to have END (P<0.05). The time from onset to thrombolysis was longer, and the score of National Institutes of Health Stroke Scale (NIHSS) and the serum S100A8/A9 level in the END group was significantly higher than in the non-END group (P<0.05). ROC curve analysis showed that the AUC of serum S100A8/A9 predicting END after rt-PA intravenous thrombolysis in AIS was 0.791 (0.692-0.891), when the best diagnostic cut-off value was 1.807 mg/mL, the corresponding sensitivity was 78.4% and the specificity was 79.0%. The history of atrial fibrillation, history of hypertension, NIHSS score, and S100A8/A9 were the influencing factors for the occurrence of END (P<0.05). Conclusion: S100A8/A9 can be used as an auxiliary index to determine whether END occurs after intravenous thrombolysis in AIS patients.