| 田宇.血清基质细胞衍生因子 1、CXC趋化因子受体 4水平在青年缺血性脑卒中病人中表达变化及临床意义[J].安徽医药,2023,27(10):2068-2071. |
| 血清基质细胞衍生因子 1、CXC趋化因子受体 4水平在青年缺血性脑卒中病人中表达变化及临床意义 |
| Expression changes and clinical significance of serum SDF-1 and CXCR4 levels in young patients with ischemic stroke |
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| DOI：10.3969/j.issn.1009-6469.2023.10.035 |
| 中文关键词: 卒中 脑梗死 基质细胞衍生因子 1 CXC趋化因子受体 4 青年人 |
| 英文关键词: Stroke Brain infarction Stromal cell-derived factor-1 CXC chemokine receptor 4 Young adult |
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| 中文摘要: |
| 目的探讨基质细胞衍生因子 1(SDF-1)、CXC趋化因子受体 4(CXCR4)水平在青年缺血性脑卒中病人中的表达及临床意义。方法回顾性选取 2019年 1月至 2021年 1月黄冈市中心医院收治的 94例青年缺血性脑卒中病人。采用酶联免疫吸附试验(ELISA)法检测两组受试者血清 SDF-1、CXCR4水平。比较不同临床表现中血清 SDF-1、CXCR4的水平变化。对青年缺血性脑卒中病人自出院后进行 3个月随访，根据改良 Rankin量表(mRS)评分对病人的预后情况进行评估，其中预后良好组 76例，预后不良组 18例。分析血清 SDF-1、CXCR4在不同预后组的水平以及与青年缺血性脑卒中病人病理特征和预后的相关性。受试者操作特征(ROC)曲线分析血清 SDF-1、CXCR4对青年缺血性脑卒中病人预后的预测价值。结果 梗死面积 >4 cm2［(6.18±1.46)μg/L、(7.24±1.71)μg/L］、美国国立卫生院神经功能缺损量表( NIHSS)评分 >15分［(5.98±1.41)μg/L、(7.15±1.68)μg/L］、格拉斯哥昏迷(GCS)评分 >8分(6.28±1.49)μg/L、(7.23±1.72)μg/L的病人血清 SDF-1、CXCR4水平均明显高于梗死面积 ≤4 cm2［(4.57±1.16)μg/ L、(5.47±1.39)μg/L］、 NIHSS评分 ≤15分［( 5.02±1.34)μg/L、(6.11±1.47)μg/L］、 GCS评分 ≤8分的病人［( 5.06±1.38)μg/L、(6.08±1.45)μg/L］(P<0.05)。预后不良组病人血清 SDF-1、CXCR4水平［( 7.01±1.71)μg/L、(8.73±1.95)μg/L］明显高于预后良好组［(5.43±1.25)μg/L、(6.17±1.49)μg/L］(P<0.05)。血清 SDF-1、CXCR4与青年缺血性脑卒中病人梗死面积、 NIHSS评分、 GCS评分、 MRS评分均为显著正相关( P<0.05)。血清 SDF-1、CXCR4水平对青年缺血性脑卒中病人预后不良预测价值的 ROC曲线下面积(AUC)分别为 0.84、0.83，灵敏度分别为 72.20%、66.70%，特异度分别为 88.20%、85.50%。结论青年缺血性脑卒中病人血清 SDF-1、CXCR4水平与病人病理程度及预后有一定的相关性，二者对青年缺血性脑卒中病人不良预后有较优的预测价值。 |
| 英文摘要: |
| Objective To investigate the expression changes and clinical significance of stromal cell-derived factor 1 (SDF-1) and CXC chemokine receptor 4 (CXCR4) levels in young patients with ischemic stroke.Methods A total of 94 young patients with ischemic stroke admitted to Huanggang Central Hospital from January 2019 to January 2021 were retrospectively selected. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum SDF-1 and CXCR4 levels of subjects in the two groups. The changes of serum SDF-1 and CXCR4 levels in different clinical manifestation were compared. The young patients with ischemic stroke were followed up for 3months after discharge, and the prognosis of the patients was evaluated according to the modified Rankin Scale (mRS) score. Among them,76 cases were in the good prognosis group and 18 cases were in the poor prognosis group. The levels of serum SDF-1 and CXCR4 in different prognostic groups and their correlation with the pathological characteristics and prognosis of young patients with ischemic stroke wereanalyzed. The predictive value of serum SDF-1 and CXCR4 on the prognosis of young patients with ischemic stroke was analyzed with receiver operating characteristic (ROC) curve.Results The levels of serum SDF-1 and CXCR4 in patients infarct size>4cm2 [(6.18±1.46)μg/L, (7.24±1.71) μg/L], the National Institutes of Health Stroke Scale (NIHSS) score>15 [(5.98±1.41) μg/L, (7.15±1.68) μg/L], GlasgowComa Scale (GCS) score>8 [(6.28±1.49) μg/L, (7.23±1.72) μg/L] were significantly higher than those in patients with infarct size ≤4cm2 [(4.57±1.16) μg/L, (5.47±1.39) μg/L], NIHSS score ≤15 [(5.02±1.34) μg/L, (6.11±1.47) μg/L], GCS score ≤8 [(5.06±1.38) μg/L, (6.08±1.45) μg/L] (P<0.05). The levels of serum SDF-1 and CXCR4 in the poor prognosis group [(7.01±1.71) μg/L, (8.73±1.95) μg/L] were significantly higher than those in the good prognosis group[(5.43±1.25) μg/L, (6.17±1.49) μg/L] (P<0.05). Serum SDF-1 and CXCR4 were significantly positively correlated with infarct size, NIHSS score, GCS score and MRS score in young ischemic stroke patients (P<0.05). The area under the ROC curve (AUC) of serum SDF-1 and CXCR4 levels for the poor prognostic value of young ischemic stroke patientswas 0.84 and 0.83, respectively, the sensitivity was 72.20% and 66.70%, respectively, and the specificity was 88.20% and 85.50%, respectively.Conclusion The levels of serum SDF-1 and CXCR4 in young patients with ischemic stroke are related to the pathologicaldegree and prognosis, and they have better predictive value for the poor prognosis of young patients with ischemic stroke. |
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