急性脑梗死患者血清组织蛋白酶S和血小板反应蛋白-1的表达及意义

The Expressions and Significance of Cathepsin S and Thrombospondin-1 in Patients with Acute Cerebral Infarction

目的 探讨急性脑梗死患者血清组织蛋白酶S(Cat S)和血小板反应蛋白-1(TSP-1)的表达及意义。方法 选取2016年10月至2017年9月于湖北省宜昌市第二人民医院收治的76例急性脑梗死患者设为观察组,并选取同期健康体检者68例设为对照组,检测所有受试者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)水平以及颈动脉内膜中膜厚度(IMT),并应用酶联免疫吸附法(ELISA)检测血清Cat S、TSP-1水平,采用Pearson法对Cat S、TSP-1间关系以及两者与血脂、颈动脉IMT进行相关性分析,采用受试者工作特征(ROC)曲线评估Cat S、TSP-1对急性脑梗死诊断效能。结果 观察组TC、TG、LDL水平显著高于对照组,HDL显著低于对照组(P<0.05);观察组血清Cat S、TSP-1水平显著高于对照组(P<0.05);Cat S与TSP-1呈正相关(P<0.05);Cat S、TSP-1分别与TC、TG、LDL、颈动脉IMT呈正相关,与HDL呈负相关(P<0.05);ROC显示Cat S诊断价值明显高于TSP-1,Cat S以69.48 pg/mL为截断值,其敏感度、特异度、约登指数分别为82.4%、86.4%、0.688;TSP-1以266.4 ng/mL为截断值,其敏感度、特异度、约登指数分别为94.1%、64.4%、0.585。结论 急性脑梗死患者血清Cat S、TSP-1水平明显升高,并在动脉粥样硬化过程中发挥重要作用,Cat S对疾病的诊断效能较TSP-1强,临床检测两者Cat S、TSP-1水平便于早期急性脑梗死的诊断。

Objective To investigate the expressions and significance of cathepsin S (Cat S) and thrombospondin-1 (TSP-1) in patients with acute cerebral infarction. Methods 76 cases of acute cerebral infarction in our hospital from October 2016 to September 2017 were selected as observation group, and 68 cases of healthy physical examiners in the same period were selected as control group. All subjects were tested for total cholesterol (TC), triacylglycerol (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) levels, and carotid intima media thickness (IMT) Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of Cat S and TSP-1 in serum, Pearson method was used to analyze the relationships between Cat S and TSP-1 with their correlation with blood lipid and carotid artery IMT,and receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of Cat S and TSP-1 in acute cerebral infarction. Results The levels of TC, TG and LDL in the observation group were significantly higher than those in the control group, and HDL was significantly lower than that in the control group (P < 0.05);serum Cat S and TSP-1 levels in the observation group were significantly higher than those in the control group (P < 0.05);there was a significant positive correlation between Cat S with TSP-1 (P < 0.05);Cat S and TSP-1 were positively correlated with TC, TG, LDL and carotid IMT respectively, and were negatively correlated with HDL (P < 0.05);ROC showed that the diagnostic value of Cat S was significantly higher than that of TSP-1, Cat S was truncated by 69.48 pg/mL, and its sensitivity, specificity and Jorden index was 82.4%, 86.4% and 0.688, respectively;the cut-off value of TSP-1 was 266.4 ng/mL, and its sensitivity, specificity and Jorden index was 94.1%, 64.4% and 0.585 respectively. Conclusion The levels of serum Cat S and TSP-1 are increased significantly in patients with acute cerebral infarction, and they play important roles in the process of atherosclerosis. The diagnostic efficiency of Cat S is stronger than that of TSP-1, clinical detection of Cat S and TSP-1 levels is helpful for early diagnosis of acute cerebral infarction.