S100β蛋白在前循环大血管闭塞患者血管内治疗的预测价值

The Predictive Value of S100βin Endovascular Treatment of Patients with Anterior Circulation Vascular Occlusion

目的探讨血清S100β蛋白在前循环急性大血管闭塞(AIS-LVO)患者血管内治疗(EVT)预后中的应用价值。方法选择2018年12月~2019年12月聊城市脑科医院卒中绿色通道接受治疗的AIS-LVO患者76例,检测外周血S100β浓度,并评估基线NIHSS评分和12周mRS评分,根据mRS评分分为功能良好组和预后不良组,比较两组临床资料、S100β浓度,并根据S100β与12周mRS评分的关系评估S100β预测患者预后的效能。结果两组性别、合并高血压、糖尿病、心房颤动及IV rt-PA比较,差异无统计学意义(P>0.05);两组年龄、NIHSS评分、再通时间及mTICI≥2b患者比较,差异有统计学意义(P<0.05);两组术后24、72h的S100β水平比较,差异有统计学意义(P<0.05)。ROC曲线分析显示,术后24 h患者S100β截断值为122.50 pg/ml时评估患者预后的灵敏度和特异度分别为68.41%、91.15%,曲线下面积为0.813(95%CI:0.691~0.935,P<0.05)。结论S100β可作为前循环AIS-LVO患者EVT后12周功能结局的预测指标,在临床中应予以重视。

Objective To investigate the application value of serum S100βprotein in the prognosis of patients with anterior circulation acute large vessel occlusion(AIS-LVO)endovascular therapy(EVT).Methods 76 AIS-LVO patients treated with stroke green channels in Liaocheng Brain Hospital from December 2018 to December 2019 were selected to detect the peripheral blood S100βconcentration,and to evaluate the baseline NIHSS score and 12-week m RS score,according to the mRS score In the group with good function and the group with poor prognosis,the clinical data and S100βconcentration of the two groups were compared,and the ability of S100βto predict the prognosis of patients was evaluated based on the relationship between S100βand the 12-week mRS score.Results There was no statistically significant difference between the two groups in terms of gender,combined hypertension,diabetes,atrial fibrillation and IV rt-PA(P>0.05);the difference in age,NIHSS score,recanalization time and m TICI≥2 b between the two groups was statistically significant(P<0.05);The difference in S100βlevels between the two groups at 24 and 72 h after operation was statistically significant(P<0.05).ROC curve analysis showed that the sensitivity and specificity of the patient’s prognosis when the S100βcutoff value was 122.50 pg/ml at 24 h after surgery were 68.41%and 91.15%,respectively,and the area under the curve was 0.813(95%CI:0.691~0.935,P<0.05).Conclusion S100βcan be used as a predictor of functional outcome in patients with AIS-LVO anterior circulation 12 weeks after EVT,and should be paid attention to in clinical practice.