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郝棚娜.血清叉头状转录因子O1、水通道蛋白4水平动态变化与急性脑梗死患者神经功能缺损及预后有关[J].内科急危重症杂志,2025,31(3):266-270
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| DOI：10.11768/nkjwzzzz20250315 |
| 中文关键词: 叉头状转录因子O1 水通道蛋白4 急性脑梗死 神经功能 预后 |
| 英文关键词: |
| 基金项目:河北省卫生健康委员办公室2022年度医学科学研究课题（20220549） |
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| 摘要点击次数: 277 |
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| 中文摘要: |
| 摘要 目的：探究血清叉头状转录因子O1（FOXO1）和水通道蛋白4（AQP4）水平的动态变化在急性脑梗死（ACI）患者神经功能和预后评估中的应用。方法：选取95例ACI患者为研究对象，根据美国国立卫生研究院卒中量表（NIHSS）评分对患者的神经功能进行评估，将其分为轻度缺损组（34例）和中重度缺损组（61例）；另根据梗死面积大小分为梗死面积≤20cm2组（73例）和梗死面积＞20cm2组（22例）；根据改良Rankin量表（mRS）评分对患者预后进行评估，分为预后良好组（72例）与预后不良组（23例）。采用酶联免疫吸附测定（ELISA）法检测研究对象血清FOXO1、AQP4水平。采用Logistic回归分析影响ACI患者神经功能缺损和预后的因素。采用受试者工作特征（ROC）曲线分析血清FOXO1、AQP4水平预测ACI患者神经功能缺损和预后的临床价值。结果：ACI患者随发病天数的增加，血清FOXO1水平逐步降低，AQP4水平逐步升高（P均＜0.05）；与轻度缺损组比较，中重度缺损组ACI患者血清FOXO1水平显著降低，AQP4水平显著升高（P＜0.05）；与梗死面积≤20cm2组比较，梗死面积＞20cm2组ACI患者血清FOXO1水平显著降低，AQP4水平显著升高（P＜0.05）；与预后良好组比较，预后不良组ACI患者血清FOXO1水平显著降低，AQP4水平显著升高（P＜0.05）。AQP4是ACI患者发生中重度神经功能缺损和不良预后的危险因素，FOXO1是其保护因素（P均＜0.05）。血清FOXO1、AQP4联合预测ACI患者中重度神经功能缺损的曲线下面积（AUC）高于二者单独预测（P均＜0.05）。结论：ACI患者血清FOXO1联合AQP4水平检测可较好预测ACI患者神经功能缺损程度和预后。 |
| 英文摘要: |
| Abstract Objective: To explore the application of dynamic changes in serum levels of box forkhead transcription factor O1 (FOXO1) and aquaporin 4 (AQP4) in the evaluation of neurological function and prognosis in patients with acute cerebral infarction (ACI). Methods: A total of 95 patients with ACI were selected as the study subjects, the neurological function of patients was evaluated according to the National Institutes of Health Stroke Scale (NIHSS) score, and they were divided into mild group (34 cases) and moderate to severe group (61 cases). According to the infarct size, the patients were divided into two groups: the infarct size ≤20cm2 group (73 cases) and the infarct size> 20cm2 group (22 cases); according to the modified Rankin scale (mRS), the prognosis of patients was evaluated and grouped into a good prognosis group and a poor prognosis group. Enzyme linked immunosorbent assay (ELISA) was applied to detect the serum levels of FOXO1 and AQP4 in the study subjects. Logistic regression analysis was applied to analyze the factors affecting neurological deficits and prognosis in patients with ACI. Receiver operating characteristic (ROC) curve was applied to analyze the clinical value of serum FOXO1 and AQP4 levels in predicting neurological function and prognosis in patients with ACI. Results: As the number of days of onset increased, serum FOXO1 levels gradually decreased and AQP4 levels gradually increased in ACI patients (all P<0.05). As compared with the mild group, the serum FOXO1 level of ACI patients in the moderate to severe defect group was significantly increased (P< 0.05), while the AQP4 level was significantly increased (P< 0.05). As compared with the group with infarction area20cm2, the serum FOXO1 level of ACI patients with infarction area> 20cm2 was significantly decreased, and the AQP4 level was significantly increased (P<0.05). As compared with the good prognosis group, the serum FOXO1 level in poor prognosis group obviously decreased (P< 0.05), while the AQP4 level obviously increased (P <0.05). AQP4 was a risk factor for moderate to severe neurological deficits and poor prognosis in patients with ACI (P< 0.05), while FOXO1 was a protective factor (P< 0.05). The area under the curve (AUC) of serum FOXO1 and AQP4 combined in predicting moderate to severe neurological deficits in patients with ACI was higher than that predicted by FOXO1 and AQP4 alone (P< 0.05). Conclusion: The detection of serum FOXO1 combined with AQP4 levels in patients with ACI can better predict the degree of neurological deficit and prognosis of patients with ACI. |
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