血清PTX3水平在急性脑梗死患者动态变化与远隔缺血后神经保护的相关性分析

doi:10.3969/j.issn.1006-6233.2022.03.014

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摘要 目的:研究血清正五聚体蛋白3(PTX3)水平在急性脑梗死(ACI)患者动态变化与远隔缺血后神经保护的相关性。方法:选择本院2019年6月至2021年6月诊治的150例ACI患者,简单随机分组法分为试验组和对照组,各75例,其中对照组给予规范化治疗,试验组在对照组基础上联用缺血预适应治疗。比较两组患者治疗不同时间点血清PTX3水平,并采用NIHSS评分评估神经功能,分析血清PTX3与神经功能相关性。治疗后90d采用mRS评分、BartheI评估患者近期预后,比较两组预后,并分析血清PTX3与预后相关性及其对预后的预测价值。结果:与治疗前比较,两组患者治疗后血清PTX3水平和NIHSS评分均显著降低,且试验组治疗后7d、14d均低于对照组(P<0.05);试验组治疗后mRS评分显著低于对照组,BartheI指数高于对照组,两者变化幅度试验组均高于对照组(P<0.05);试验组患者血清PTX3水平与NIHSS评分、mRS评分呈正相关,与BartheI指数呈负相关(P<0.05);血清PTX3>3.34μg/L预测ACI患者预后ROC曲线的曲线下面积为0.948,敏感度为92.86%,特异度为82.26%,(P<0.05)。结论:血清PTX3水平与ACI患者神经功能缺损以及预后显著相关,且PTX3可辅助用于ACI患者RIC治疗后神经功能缺损评估以及近期预后预测指标。

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关键词 ：急性脑梗死, 正五聚体蛋白3, 远隔缺血后神经保护, 相关性

Abstract：Objective: To study the correlation between dynamic changes of serum pentraxin 3 (PTX3) and neuroprotection after remote ischemia in patients with acute cerebral infarction (ACI). Methods: A total of 150 patients with ACI treated in the hospital between June 2019 and June 2021 were enrolled and divided into experimental group and control group by simple random grouping method, 75 cases in each group. The control group was given standardized treatment, while the experimental group was given ischemic preconditioning treatment on the basis of the control group. The level of serum PTX3 was compared between the two groups. The nerve function was assessed by NIHSS score, and its correlation with serum PTX3 was analyzed. At 90d after treatment, short-term prognosis was assessed by mRS score and BartheI index. The prognosis between the two groups was compared. The correlation between serum PTX3 and prognosis and its predictive value for prognosis were analyzed. Results: After treatment, level of serum PTX3 and NIHSS score in both groups were significantly decreased, which were lower in experimental group than in control group at 7d and 14d after treatment (P<0.05). After treatment, the experimental group had significantly lower mRS scores, and higher BartheI index than the control group. The changes were greater in the experimental group than in the control group (P<0.05). The level of serum PTX3 was positively correlated with NIHSS and mRS scores, while negatively correlated with BartheI index (P<0.05). The area under the ROC curve (AUC), sensitivity, and specificity of serum PTX3>3.34μg/L to predict the prognosis of patients with ACI were 0.948, 92.86%, and 82.26% (P<0.05). Conclusion: The level of serum PTX3 is significantly correlated with neurological deficits and prognosis in ACI patients, which can be applied to assessing neurological deficits and predict short-term prognosis in ACI patients after RIC.

Key words： Acute cerebral infarction Pentraxin 3 Neuroprotection after remote ischemia Correlation

基金资助:沈阳医学院科技基金项目,(编号:20192056)

引用本文:

姚晓濛, 杨小营, 马莉. 血清PTX3水平在急性脑梗死患者动态变化与远隔缺血后神经保护的相关性分析[J]. 河北医学, 2022, 28(3): 417-421.
YAO Xiaomeng, et al. Correlation Between Dynamic Changes of Serum PTX3 and Neuroprotection After Remote Ischemia in Patients with Acute Cerebral Infarction. HeBei Med, 2022, 28(3): 417-421.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.03.014 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I3/417

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