| 朱召蕾,霍瑞民,赵俊杰.ABCD2评分联合血清 YKL-40、sFGL2对短暂性脑缺血发作后发生脑梗死的预测价值[J].安徽医药,2025,29(5):927-931. |
| ABCD2评分联合血清 YKL-40、sFGL2对短暂性脑缺血发作后发生脑梗死的预测价值 |
| Clinical value of ABCD2 score combined with serum YKL-40 and sFGL2 in predicting the occurrence of cerebral infarction after transient ischemic attack |
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| DOI：10.3969/j.issn.1009-6469.2025.05.014 |
| 中文关键词: 脑梗死 ABCD2评分 甲壳质酶蛋白 -40 可溶性纤维蛋白原 2 脑缺血发作，短暂性 |
| 英文关键词: Brain infarction Age blood pressure,clinicalfeatures,durationnofsymptoms,diabetes score Chitinase protein-40 Sol-uble fibrinogen 2 Ischemic attack, transient |
| 基金项目:河北省医学科学研究计划项目( 20220485) |
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| 中文摘要: |
| 目的探索年龄、血压、临床特征、症状持续时间、糖尿病评分( ABCD2)评分联合血清甲壳质酶蛋白 -40(YKL-40)、可溶性纤维蛋白原 2(sFGL2)预测短暂性脑缺血发作( TIA)后发生脑梗死( CI)的临床价值。方法选取 2022年 4月至 2023年 4月邯郸市第一医院收治的 253例 TIA病人作为研究对象，其中脑梗死组 98例，非脑梗死组 155例。收集病人的临床资料，对两组病人血清中三酰甘油( TG)、低密度脂蛋白胆固醇( LDL-C)、高密度脂蛋白胆固醇( HDL-C)、总胆固醇( TC)、空腹血糖( FBG)、血尿酸( BUA)及 YKL-40、sFGL2水平进行检测，并进行 ABCD2评分；多因素 logistic回归分析影响因素；受试者操作特征曲线(ROC曲线)分析预测价值。结果脑梗死组中高脂血症病人比例，发作次数、发作至就诊时间以及持续时间均高于非脑梗死组( P<0.05)脑梗死组病人血清 TG、sFGL2水平分别为( 1.78±0.14)mmol/L、(20.53±1.77)μg/L低于非脑梗死病人( 2.73±0.26) mmol/L、(23.35，±2.38)μg/L，血清 BUA、YKL-40水平和 ABCD2评分分别为( 328.43±25.36)μmol/L、(94.56±9.47)μg/L、(3.03±0.52)分高于非脑梗死病人(285.47±26.41)μmol/L、(83.26±7.88)μg/L、(2.46±0.31)分，差异有统计学意义( P<0.05)；多因素 logis-tic回归分析显示发作次数、发作至就诊时间、持续时间、血清 YKL-40和 sFGL2水平、 ABCD2评分是 TIA后发生脑梗死的影响因素( P<0.05)；曲线下面积( AUC)显示， ABCD2评分联合 YKL-40、sFGL2预测 TIA后脑梗死的 AUC为 0.93，95%CI:(0.89，0.96)，联合诊断的 AUC显著大于 YKL-40单独预测的 AUC(Z=5.73，P<0.001)sFGL2单独预测的 AUC(Z=4.73，P<0.001)ABCD2评分单独预测的 AUC(Z=5.58，P<0.001)。结论 TIA后发生脑梗死病人YKL-40水平升高，血清 sFGL2水平降低BCD2评分血清，A，联合血清 YKL-40和 sFGL2预测 TIA后发生脑梗死风险的价值更高。 |
| 英文摘要: |
| Objective To explore the clinical value of ABCD2 score combined with serum chitinase protein-40 (YKL-40) and soluble fibrinogen 2 (sFGL2) in predicting cerebral infarction (CI) after transient ischemic attack (TIA).Methods A total of 253 TIA patientsadmitted in Handan First Hospital from April 2022 to April 2023 were selected for the study, including 98 cases in the cerebral infarc-tion group and 155 cases in the non-cerebral infarction group. The clinical data of the patients were collected, and the serum levels of TG, LDL-C, HDL-C, TC, FBG, blood uric acid (BUA), and YKL-40 and sFGL2 were tested in both groups, and the ABCD2 score wasperformed. Multifactor logistic regression was used to analyze impact factors. ROC curve analysis was used to analyze the predictive val-ue.Results The proportion of patients with hyperlipidemia, the number of episodes, the time between episodes and clinic visits, andthe duration were higher in the cerebral infarction group than in the non-cerebral infarction group (P<0.05). The serum TG and sFGL2levels of patients in the cerebral infarction group were (1.78±0.14) mmol/L, (20.53±1.77) μg/L lower than those of patients with non-ce-rebral infarction (2.73±0.26) mmol/L, (23.35±2.38) μg/L, and the serum BUA and YKL-40 levels and ABCD2 score were ( 328.43±25.36) μmol/L, (94.56±9.47) μg/L, and (3.03±0.52) scores were higher than those of non-cerebral infarction patients (285.47±26.41)μmol/L, (83.26±7.88) μg/L, and (2.46±0.31) scores, and the difference was statistically significant (P<0.05). Multivariate logistic re-gression analysis showed that the number of attacks, the time from attack to treatment, the duration, serum YKL-40 and sFGL2 levels, and ABCD2 score were the influencing factors of CI after TIA (P<0.05); the area under the ROC curve (AUC) showed that the AUC of CI predicted by the combination of ABCD2 score and YKL-40, sFGL2 after TIA was 0.93,95%CI:(0.89, 0.96), the AUC of the combina-tion diagnosis was obviously higher than that predicted by YKL-40 alone (Z=5.73, P<0.001), the AUC predicted by sFGL2 alone (Z= 4.73, P<0.001), and the AUC predicted by ABCD2 score alone (Z=5.58, P<0.001). Conclusions The serum YKL-40 level is in-creased and serum sFGL2 level is decreased in patients with CI after TIA. The ABCD2 score combined with serum YKL-40 and sFGL2 has a higher value in predicting the risk of CI after TIA. |
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