| 苏晓辉,齐秀彦,张瑞丹.血清 Orexin-A、METTL3与进展性脑梗死病人神经功能缺损、梗死体积及预后的相关性研究[J].安徽医药,2026,30(10):2007-2011. |
| 血清 Orexin-A、METTL3与进展性脑梗死病人神经功能缺损、梗死体积及预后的相关性研究 |
| Correlation of serum Orexin-A and METTL3 Levels with neurological deficits, infarct volume, and prognosis in patients with progressive stroke |
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| DOI：10.3969/j.issn.1009-6469.2026.10.019 |
| 中文关键词: 脑梗死 食欲素 A 甲基转移酶样蛋白 3 神经功能缺损 梗死体积 预后 |
| 英文关键词: Brain infarction Orexin-A Methyltransferase-like 3 Neurological deficits Infarct volume Prognosis |
| 基金项目:河北省医学科学研究重点项目( 20191480) |
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| 中文摘要: |
| 目的探讨血清食欲素 A(Orexin-A)、甲基转移酶样蛋白 3(METTL3)与进展性脑梗死( PS)病人神经功能缺损、梗死体积及预后的相关性。方法前瞻性研究。选取 2022年 1月至 2024年 5月石家庄市人民医院收治的 191例急性脑梗死( ACI)病人，根据是否发展为 PS分为 PS组( n=89)和非 PS组( n=102)； PS组根据神经功能缺损程度分为轻度组( n=29)中度组( n=39)和重度组( n=21)根据梗死体积分为大梗死灶组( n=19)、中梗死灶组( n=34)和小梗死灶组( n=36)，根据预后分为、良好组( n=48)和不良组( n=41)，。酶联免疫吸附分析检测血清 Orexin-A水平；实时荧光定量聚合酶链式反应( qRT-PCR)法检测血清 METTL3水平； Spearman和 Pearson法分析相关性；多因素 logistic回归分析筛选 PS病人预后影响因素；受试者操作特征曲线(ROC曲线)分析血清 Orexin-A、METTL3水平对 PS病人预后的预测价值。结果 PS组血清 Orexin-A、METTL3水平均显著低于非 PS组［(386.51±37.54)ng/L比(492.53±48.33)ng/L，0.64±0.09比 1.01±0.11，P<0.05］；轻、中、重度组病人美国国立卫生研究院卒中量表(NIHSS)评分逐渐升高(P<0.05)血清 Orexin-A、METTL3水平逐渐降低( P<0.05)；小、中、大梗死灶组病人脑梗死体积逐渐增加(P<0.05)，血清 Orexin-A、METTL3水，平逐渐降低( P<0.05)； PS病人血清 Orexin-A、METTL3水平与 NIHSS评分、梗死体积呈负相关( P<0.05)；多因素 logistic回归分析发现， Orexin-A、METTL3是 PS病人预后保护因素( P<0.05)； ROC曲线分析结果显示，血清 Orexin-A水平预测 PS病人预后的曲线下面积( AUC)值为 0.75，METTL3预测 PS病人预后的 AUC值为 0.78，二者联合预测的 AUC值为 0.86，优于单个指标( Z=2.82、2.25，P<0.05)。结论 PS病人血清 Orexin-A、METTL3水平均显著降低，与 PS病人神经 |
| 英文摘要: |
| Objective To investigate the correlation between serum levels of Orexin-A and methyltransferase-like 3 (METTL3) and neurological deficits, infarction volume, and prognosis in patients with progressive stroke (PS).Methods Prospective study. A total of191 patients with acute cerebral infarction (ACI) admitted to Shijiazhuang People's Hospital from January 2022 to May 2024 were en-rolled and divided into a PS group (n=89) and a non-PS group (n=102) according to whether they developed PS. The PS group was further subdivided into mild (n=29), moderate (n=39), and severe (n=21) subgroups based on the degree of neurological impairment; into large infarct (n=19), medium infarct (n=34), and small infarct (n=36) subgroups according to infarct volume; and into favorable (n=48) and un-favorable (n=41) subgroups according to prognosis. Enzyme linked immunosorbent assay (ELISA) was used to measure serum Orexin-A levels; real-time quantitative fluorescent PCR (qRT-PCR) was used to measure serum METTL3 levels; Spearman's and Pearson's corre-lation analyses were performed; multivariate logistic regression was applied to identify factors influencing the prognosis of PS patients;and receiver operating characteristic curves (ROC curves) were used to assess the predictive value of serum Orexin-A and METTL3 lev-els for prognosis. Results Serum levels of Orexin-A and METTL3 in the PS group were significantly lower than those in the non-PS group [(386.51±37.54) ng/L vs. (492.53±48.33) ng/L, (0.64±0.09) vs. (1.01±0.11); both P<0.05]. In the mild, moderate, and severe sub-groups, the National Institutes of Health Stroke Scale (NIHSS) scores increased progressively (P<0.05), while serum Orexin-A and MET-TL3 levels decreased progressively (P<0.05). Similarly, in the small, medium, and large infarct subgroups, cerebral infarct volume in-creased progressively (P<0.05), while serum Orexin-A and METTL3 levels decreased progressively (P<0.05). In PS patients, serum Orexin-A and METTL3 levels were negatively correlated with NIHSS scores and infarct volume (P<0.05). Multivariate logistic regression analysis revealed that Orexin-A and METTL3 were prognostic protective factors in PS patients (P<0.05). ROC curve analysis revealed that the area under the curve (AUC) for serum Orexin-A in predicting prognosis was 0.75, for METTL3 was 0.78, and the AUC for thecombined prediction of both markers was 0.86, which was superior to that of either marker alone (Z=2.82, 2.25, P<0.05).Conclusion Serum levels of Orexin-A and METTL3 were significantly reduced in PS patients, and were closely associated with neurological deficits,cerebral infarct volume, and prognosis in these patients; furthermore, Orexin-A and METTL3 have certain predictive value for the prog-nosis of PS patients. |
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