摘要
目的探讨不同NIHSS评分缺血性脑卒中(CIS)患者血清组织蛋白酶S(CatS)、视锥蛋白样蛋白-1(VILIP-1)、胱抑素C(CysC)水平变化及其与疾病转归的相关性。方法选取2021-01—2023-01南阳市中心医院收治的143例CIS患者为研究对象,根据入院时NIHSS评分分为低分组(43例,NIHSS评分<4分)、中分组(68例,NIHSS评分4~15分)和高分组(32例,NIHSS评分>15分)。比较3组入院时血清CatS、VILIP-1、CysC水平,分析其与NIHSS评分的相关性,比较不同疾病转归患者血清各指标水平,偏回归分析CIS患者转归不良的影响因素,ROC分析各指标联合检测对CIS患者转归不良的预测价值。结果入院时低分组血清CatS、VILIP-1、CysC水平分别为(53.18±6.74)ng/L、(4.57±1.38)μg/L、(1.08±0.32)mg/L,低于中分组[(76.53±9.25)ng/L、(9.63±2.44)μg/L、(1.74±0.39)mg/L]和高分组[(98.44±8.61)ng/L、(16.72±3.55)μg/L、(2.53±0.47)mg/L],各指标水平与NIHSS评分均呈正相关(P<0.05)。治疗1周、2周后转归不良患者血清CatS、VILIP-1、CysC水平[治疗1周后:(73.35±8.44)ng/L、(9.25±2.44)μg/L、(1.73±0.33)mg/L;治疗2周后:(70.96±9.02)ng/L、(8.74±2.13)μg/L、(1.71±0.30)mg/L]高于转归良好患者[治疗1周后:(55.87±6.29)ng/L、(6.15±2.03)μg/L、(1.01±0.31)mg/L;治疗2周后:(31.95±6.24)ng/L、(2.86±0.74)μg/L、(0.64±0.19)mg/L](P<0.05)。治疗1周、治疗2周后血清CatS、VILIP-1、CysC水平为CIS患者转归不良的危险因素,联合检测预测CIS患者转归不良的AUC分别为0.784、0.838。结论血清CatS、VILIP-1、CysC水平与CIS患者神经功能损伤程度及疾病转归密切相关,联合检测可作为临床判断神经功能损伤程度、预测转归情况的有效依据。
Objective To investigate the changes in serum levels of cathepsin S(CatS),visinin-like protein 1(VILIP-1),and cystatin C(CysC)in patients with cerebral ischemic stroke(CIS)according to different NIHSS scores and their correlation with disease outcomes.Methods A total of 143 CIS patients admitted to Nanyang Central Hospital from January 2021 to January 2023 were selected as the research subjects,and were divided into low group(43 cases,NIHSS score<4 points),medium group(68 cases,NIHSS score 4-15 points),and high group(32 cases,NIHSS score>15 points)based on the NIHSS score at admission.Serum levels of CatS,VILIP-1 and CysC were compared among the three groups at admission,and their correlation with NIHSS score was analyzed.Serum levels of various indexes in patients with different disease outcomes were compared.The influencing factors for poor outcomes in CIS patients were analyzed by partial regression,and the predictive value of combined detection of all indexes for poor outcomes in CIS patients was analyzed by ROC.Results The serum CatS,VILIP-1,and CysC levels at admission in the low group was(53.18±6.74)ng/L,(4.57±1.38)μg/L,and(1.08±0.32)mg/L,respectively,which were lower than the medium group((76.53±9.25)ng/L,(9.63±2.44)μg/L,(1.74±0.39)mg/L)and high group((98.44±8.61)ng/L,(16.72±3.55)μg/L,and(2.53±0.47)mg/L),and the levels of all indicators were positively correlated with NIHSS scores(P<0.05).After 1 week and 2 weeks of treatment,the serum CatS,VILIP-1,and CysC levels of patients with poor prognosis(after 1 week of treatment:(73.35±8.44)ng/L,(9.25±2.44)μg/L,(1.73±0.33)mg/L;after 2 weeks of treatment:(70.96±9.02)ng/L,(8.74±2.13)μg/L,(1.71±0.30)mg/L)were higher than those of patients with good prognosis(after 1 week of treatment:(55.87±6.29)ng/L,(6.15±2.03)μg/L,(1.01±0.31)mg/L;after 2 weeks of treatment:(31.95±6.24)ng/L,(2.86±0.74)μg/L,(0.64±0.19)mg/L,P<0.05).Serum CatS,VILIP-1 and CysC levels after 1 week and 2 weeks of treatment were risk factors for poor outcome in CIS patients,and the combined test predicted the AUC of poor outcome in CIS patients was 0.784 and 0.838,respectively.Conclusion Serum CatS,VILIP-1 and CysC levels are closely related to the degree of neurological impairment and the outcome of CIS patients.The combined detection of CATS,VilIP-1 and CYSC levels can be used as an effective basis for clinical judgment of the degree of neurological impairment and prognosis.
作者
刘义锋
余洋
刘少哲
张东焕
孙孟
温昌明
LIU Yifeng;YU Yang;LIU Shaozhe;ZHANG Donghuan;SUN Meng;WEN Changming(Nanyang Central Hospital,Nanyang 471003,China)
出处
《中国实用神经疾病杂志》
2025年第2期223-227,共5页
Chinese Journal of Practical Nervous Diseases
基金
河南省科技攻关项目(编号:232102310198)。
