血清视黄醇结合蛋白4与急性缺血性卒中患者卒中严重程度和短期转归的相关性

Correlation between serum retinol-binding protein 4 and stroke severity and short-term outcome in patients with acute ischemic stroke

目的探讨血清视黄醇结合蛋白4(retinol binding protein 4,RBP4)水平与急性缺血性卒中患者卒中严重程度和短期转归的相关性。方法回顾性纳入2017年1月至2017年12月安徽医科大学第三附属医院神经内科收治的在发病2周内就诊且未接受溶栓或血管内治疗的急性缺血性卒中患者。在入院24 h内检测血清RBP4水平,记录患者人口统计学及基线临床资料。在入院当天采用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评估神经缺损程度,≤8分定义为轻度卒中,>8分定义为中重度卒中。在出院时或发病后14 d采用改良Rankin量表评价短期转归,0~2分定义为转归良好,>2分定义为转归不良。结果共纳入235例患者,男性134例(57%),女性101例(43%);年龄(66.8±12.7)岁(范围28~93岁)。轻度卒中200例(85.1%),中重度卒中35例(14.9%);171例(72.8%)转归良好,64例(27.2%)转归不良。单变量分析显示,中重度卒中组血清RBP4水平显著低于轻度卒中组[(29.28±10.43)mg/L对(36.88±10.61)mg/L;t=3.920,P<0.001],转归不良组RBP4水平显著低于转归良好组[(32.03±11.33)mg/L对(37.14±10.44)mg/L;t=3.264,P=0.001]。多变量logistic回归分析显示,高血清RBP4水平与卒中严重程度较轻(优势比0.917,95%可信区间0.874~0.962;P<0.001)和短期转归良好(优势比0.955,95%可信区间0.927~0.983;P=0.002)独立相关。结论高血清RBP4水平的急性缺血性卒中患者卒中严重程度较轻,短期转归更好。

Objective To investigate the correlation between serum retinol-binding protein 4(RBP4)level and stroke severity and short-term outcome in patients with acute ischemic stroke.Methods From January 2017 to December 2017,patients with acute ischemic stroke admitted to the Department of Neurology,the Third Affiliated Hospital of Anhui Medical University and who did not receive thrombolytic or endovascular treatment were enrolled retrospectively within 2 weeks of onset.The serum RBP4 levels were measured within 24 h of admission and the demographics and baseline clinical data of the patients were documented.On the day of admission,the National Institutes of Health Stroke Scale(NIHSS)was used to assess the degree of neurological deficit;≤8 was defined as mild stroke and>8 was defined as moderate to severe stroke.The modified Rankin scale was used to assess the short-term outcomes at the time of discharge or 14 days after onset;0 to 2 were defined as good outcomes,and>2 was defined as poor outcome.Results A total of 235 patients were enrolled,including 101 females(43%)and 134 males(57%);aged(66.8±1.7)years(range 28-93 years).There were 200 mild strokes(85.1%)and 35 moderate to severe strokes(14.9%);171(72.8%)had good outcomes and 64(27.2%)had poor outcomes.Univariate analysis showed that the serum RBP4 level in the moderate to severe stroke group was significantly lower than that in the mild stroke group(29.28±10.43 mg/L vs.36.88±10.61 mg/L;t=3.920,P<0.001),and the RBP4 level in the poor outcome group was significantly lower than that in the good outcome group(32.03±11.33 mg/L vs.37.14±10.44 mg/L;t=3.264,P=0.001).Multivariate logistic regression analysis showed that the high serum RBP4 level was independently correlated with the milder stroke severity(odds ratio 0.917,95%confidence interval 0.874-0.962;P<0.001)and short-term poor outcome(odds ratio 0.955,95%confidence interval 0.927-0.983;P=0.002).Conclusion In patients with high serum RBP4 levels,acute ischemic stroke is less severe and better in short-term outcomes.