血清CXCL12和IL-33在急性缺血性脑卒中预后评估中的价值

Prognostic value of serum CXCL12 and IL-33 levels in patients with acute ischemic stroke

目的:探讨血清CXCL12和IL-33在急性缺血性脑卒中预后评估中的价值。方法:选取2014年12月至2016年6月到本院就诊的急性缺血性脑卒中患者作为病例组(122例),同时选取本院同期健康体检人群作为正常组(59名),采用ELISA法检测研究对象入组时血清CXCL12和IL-33的水平。参照mRS评分将患者分为预后良好组(86例)和预后不良组(36例),并通过受试者工作特征曲线(ROC)和曲线下面积(AUC)评价血清CXCL12和IL-33在急性缺血性脑卒中患者预后评估中的作用。结果:急性缺血性脑卒中患者血清CXCL12水平明显高于对照组[8.0 ng/ml(IQR,6.7-8.9)VS 3.0 ng/ml(IQR,2.3-3.8),P<0.001],IL-33水平明显高于对照组[65.25 ng/L(IQR,56.05-71.08)VS 35.30 ng/L(IQR,26.73-42.55),P<0.001];急性缺血性脑卒中预后良好组患者血清CXCL12水平明显低于预后不良组[7.4 ng/ml(IQR,6.3-8.3)VS 9.3 ng/m L(IQR,8.3-11.1),P<0.001],预后良好组患者IL-33水平明显高于预后不良组[66.81 ng/L(IQR,61.12-73.29)VS.55.38ng/L(IQR,46.75-64.71),P<0.001]。经Pearson相关性分析显示血清CXCL12和IL-33水平与mRS评分分别呈正相关和负相关(r=0.524,P<0.001;r=-0.443,P<0.001)。血清CXCL12、IL-33评估急性缺血性脑卒中预后的曲线下面积分别为0.835、0.784,灵敏度分别为77.8%、83.4%,特异度分别为73.3%、66.7%。结论:血清CXCL12和IL-33可能作为急性缺血性脑卒中患者预后评估的标志物。

Objective: To explore the prognostic value of serum CXCL12 and IL-33 levels in patients with acute ischemic stroke. Methods: From December 2014 to June 2016,the patients with acute ischemic stroke in our hospital as the case group( 122cases) and healthy volunteer were recruited as normal group( 59 cases). According to the mRS scores patients were divided into favorable outcomes group( 86 cases) and unfavorable outcomes group( 36 cases). On admission the serum CXCL12 and IL-33 levels of objects were measured by ELISA. Receiver operating characteristic curve( ROC) and AUV were used to evaluate the prognostic value serum CXCL12 and IL-33 in patients with acute ischemic stroke. The serum CXCL12 levels were significantly higher in the patients with acute ischemic stroke compared to the control group[8. 0 ng/ml( IQR,6. 7-8. 9) VS 3. 0 ng/ml( IQR,2. 3-3. 8),P < 0. 001 ],and serum IL-33 levels were also significantly higher than those in the control group[65. 25 ng/L( IQR,56. 05-71. 08) VS 35. 30 ng/L( IQR,26. 73-42. 55),P<0. 001]. The serum CXCL12 levels were significantly lower in patients with a favorable outcome group[7. 4ng/ml( IQR,6. 3-8. 3) ] compared with patients with an unfavorable outcome group[9. 3 ng/ml( IQR,8. 3-11. 1) ],and IL-33 levels were also significantly lower than that of unfavorable outcomes group[66. 81 ng/L( IQR,61. 12-73. 29) VS 55. 38 ng/L( IQR,46. 75-64. 71),P < 0. 001]. Pearson correlation analysis showed that serum CXCL12 and IL-33 levels were respectively positively and negatively correlated with mRS score( r = 0. 524,P<0. 001; r =-0. 443,P<0. 001). The serum CXCL12 and IL-33 levels as an indicator for prognosis of functional outcome. The area under the curve was 0. 835,0. 784 respectively. The sensitivity was 77. 8%,83. 4%respectively and specificity was 73. 3%,66. 7% respectively. Conclusion: Serum CXCL12 and IL-33 levels can be used as markers for the prognosis of patients with acute ischemic stroke.