| 赖娅莉,刘信东,段海宇.血清神经胶质纤维酸性蛋白、泛素羧基端水解酶 L1水平与脑梗死病情及预后的关系[J].安徽医药,2022,26(4):760-764. |
| 血清神经胶质纤维酸性蛋白、泛素羧基端水解酶 L1水平与脑梗死病情及预后的关系 |
| Relationship between serum GFAP and UCH-L1 levels and the severity and prognosis of patients with acute cerebral infarction |
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| DOI：10.3969/j.issn.1009-6469.2022.04.027 |
| 中文关键词: 脑梗死 神经胶质纤维酸性蛋白 泛素羧基端水解酶 L1 预后 |
| 英文关键词: Brain infarction Glial fibrilla y acidic protein Ubiquitin carboxy-terminal hydrolase L1 Prognosis |
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| 中文摘要: |
| 目的探究血清神经胶质纤维酸性蛋白(GFAP)、泛素羧基端水解酶 L1(UCH-LI)水平与急性脑梗死(ACI)病人病情严重程度及预后的关系。方法选择 2015年 6月至 2019年 2月核工业四一六医院收治的 ACI病人 136例，根据美国国立卫生院研究卒中表( NIHSS)评分分为轻度组( <5分， n=57)、中度组( 5~15分， n=43)和重度组( >15分， n=36)根据改良 Rankin量表(mRS)评分分为预后良好组( 0~2分， n=72)与预后不良组( 3~6分， n=64)。另取同期门诊健康体检者 60例，为对照组，采用酶联免疫吸附试验( ELISA)检测所有受试者血清 GFAP、UCH-L1水平，采用 Spearman法分析其与 NIHSS评分的相关性，采用 logistic回归分析影响 ACI病人预后的危险因素。绘制受试者工作特性曲线( ROC)分析血清 GFAP、UCH-L1水平与 NIHSS评分对 ACI病人不良预后的预测价值。结果与对照组 ACI病人 NIHSS评分( 0.00±0.00)分、血清 GFAP［0.06(0.04，0.11)］μg/L、UCH-L1［0.06(0.03，0.16)］μg/L水平比较，轻、中、重度组 ACI病人 NIHSS评分［( 3.12±0.29)分、(9.02±1.15)分、(19.27±2.35)分］、血清 GFAP［0.13(0.04，0.18)μg/L、0.16(0.07，0.26)μg/L、0.32(0.07，1.01)μg/L］、 UCH-L1P［0.10(0.07，0.23)μg/L、0.21(0.13，0.38)μg/L、 |
| 英文摘要: |
| Objective To explore the relationship between serum glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl-termi nal hydrolase L1 (UCH-LI) levels and the severity and prognosis of patients with acute cerebral infarction (ACI).Methods One hun dred and thirty-six ACI patients who admitted to No. 416 Hospital of Nuclear Industry from June 2015 to February 2019 were selected.They were assigned into mild group (≤5 points, n = 57), moderate group (5-15 points, n = 43), and severe group (≥16 points, n = 36) ac cording to the National Institutes of Health Research Stroke Scale (NIHSS) score, and they were assigned into good prognosis group (0-2 points, n = 72) and poor prognosis group (3-6 points, n = 64) according to the modified Rankin Scale (mRS) score. 60 serum samplesfrom healthy physical examination patients in the same period were selected as the control group, the serum GFAP and UCH-L1 levels of all subjects were detected by Enzyme-linked immunosorbent assay (ELISA), and their correlation with the NIHSS score was analyzedby Spearman method. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum GFAP, UCHL1 and NIHSS scores for adverse prognosis of ACI patients.Results Compared with the NIHSS scores (0.00±0.00) score, serum GFAP 0.06(0.04,0.11) μg/L, and UCH-L1 0.06(0.03,0.16) μg/L levels of the control group, the NIHSS scores [(3.12±0.29) score, (9.02±1.15)score, (19.27±2.35) score], serum GFAP [0.13(0.04,0.18) μg/L, 0.16(0.07,0.26) μg/L,0.32 (0.07,1.01) μg/L], and UCH-L1 [0.10(0.07,0.23) μg/L, 0.21(0.13,0.38) μg/L, 0.32(0.12,0.62) μg/L] levels of ACI patients in the mild, moderate, and severe groups increased se quentially (P <0.05). Spearman correlation analysis showed that serum GFAP and UCH-L1 levels were positively correlated with NI HSS scores in patients with ACI (r = 0.43, 0.41, P < 0.05). Compared with the the age (61.72±6.21) age, NIHSS score (7.61±1.89)score, serum FBG (5.15±0.83) mmol/L, CPR (2.75±0.82) mmol/L, GFAP 0.07(0.03,0.18) μg/L, and UCH-L1 0.04(0.11,0.22) μg/L lev els of the good prognosis group, the age (65.83±5.69) age, NIHSS score (13.14±2.05) score, serum FBG (6.39±1.07) mmol/L, CPR(3.96±1.03) mmol/L, GFAP 0.16(0.10,0.33) μg/L, and UCH-L1 0.13(0.09,0.20) μg/L levels of the poor prognosis group increased (P < 0.05). Multivariate Logistic regression analysis showed that the NIHSS score, high serum GFAP, and UCH-L1 levels were risk factors affecting the poor prognosis of patients with ACI (P < 0.05). The AUC of the three tests was 0.953, and the sensitivity and specificitywere 82.80% and 97.20%, which were significantly better than the single test.Conclusions Elevated serum GFAP and UCH-L1 lev els ARE positively correlated with increased disease severity in patients with ACI, and are independent risk factor affecting the poorprognosis of ACI patients. Serum GFAP, UCH-L1 combined with NIHSS scores are of higher value for ACI adverse prognostic assess ment and have certain clinical reference. |
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