摘要
目的探讨血清可溶性凝集素样氧化型低密度脂蛋白受体-1(sLOX-1)、内皮细胞特异性分子-1(ESM-1)对急性缺血性脑卒中(AIS)患者重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗后发生出血转化(HT)的预测价值。方法选择2020年1月至2022年6月在宝鸡市人民医院接受rt-PA静脉溶栓治疗的AIS患者320例为研究对象,根据治疗后头颅CT复查结果分为HT组和非HT组,采用酶联免疫吸附试验检测两组患者的血清sLOX-1、ESM-1水平,并进行比较;采多因素Logistic回归分析rt-PA静脉溶栓后发生HT的影响因素;采用受试者工作特征(ROC)曲线分析血清sLOX-1、ESM-1对rt-PA静脉溶栓后发生HT的预测价值。结果治疗36 h后,47例患者发生HT(HT组),HT发生率为14.69%(47/320),剩余273例未发生HT患者为非HT组。HT组年龄、合并高血压患者占比、入院时NIHSS评分、治疗前血清sLOX-1和ESM-1水平高于非HT组(P<0.05)。多因素Logistic回归分析结果显示,入院时NIHSS评分>13.04分、血清sLOX-1>0.92 ng/mL、血清ESM-1>1.24μg/mL是AIS患者静脉溶栓后发生HT的独立危险因素(P<0.05)。治疗前血清sLOX-1、ESM-1单独及联合检测预测rt-PA静脉溶栓后发生HT的曲线下面积(AUC)分别为0.797、0.775和0.840。结论血清sLOX-1、ESM-1是AIS患者rt-PA静脉溶栓后发生HT的影响因素,二者联合检测对其具有较高的预测价值。
Objective To investigate the predictive value of serum soluble lectin-like oxidized low density lipoprotein receptor-1(sLOX-1)and endothelial cell specific molecule-1(ESM-1)for hemorrhagic transformation(HT)after recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis in patients with acute ischemic stroke(AIS).Methods A total of 320 AIS patients who received rt-PA intravenous thrombolysis in Baoji People's Hospital from January 2020 to June 2022 were selected and divided into HT group and non-HT group according to the results of head CT reexamination after treatment,the levels of serum sLOX-1 and ESM-1 in both groups were detected by enzyme-linked immunosorbent assay and compared,the influencing factors of HT after rt-PA intravenous thrombolysis were analyzed by multivaria Logistic regression analysis,the predictive value of serum sLOX-1 and ESM-1 for HT after rt-PA intravenous thrombolysis was analyzed by receiver operating characteristic(ROC)curve.Results HT occurred in 47 patients after 36 h of treatment(HT group),with an HT incidence of 14.69%(47/320),and the remaining 273 patients who did not experience HT were in the non-HT group.The age,proportion of patients with hypertension,NIHSS score at admission,serum sLOX-1 and ESM-1 levels before treatment in HT group were higher than those in non-HT group(P<0.05).Multivariate Logistic regression analysis showed that NIHSS score>13.04,serum sLOX-1>0.92 ng/mL and serum ESM-1>1.24μg/mL were independent risk factors for HT after intravenous thrombolysis in AIS patients(P<0.05).The area under the curve(AUC)of serum sLOX-1,ESM-1 alone and combined detection in predicting HT after rt-PA intravenous thrombolysis before treatment were 0.797,0.775 and 0.840 respectively.Conclusion Serum sLOX-1 and ESM-1 are the influencing factors of HT after rt-PA intravenous thrombolysis in AIS patients,and the combine detection of the two indicators has high predictive value.
作者
赵浩
王敏博
张子豪
ZHAO Hao;WANG Minbo;ZHANG Zihao(Department of Internal Medicine-Neurology,Baoji People's Hospital,Baoji,Shaanxi 721000,China;Department of Internal Medicine-Neurology,Qishan County Hospital,Baoji,Shaanxi 722400,China)
出处
《检验医学与临床》
2024年第3期333-337,共5页
Laboratory Medicine and Clinic
基金
陕西省卫生健康委员会2022年度健康科研项目(2022D0045)。
