血清糖晚期基化终末产物及可溶性晚期糖基化终末产物受体水平与急性脑梗死后出血性转化的相关性

Correlation between serum AGEs and sRAGE levels and hemorrhagic transformation after acute cerebral infarction

目的分析急性脑梗死(ACI)患者血清糖晚期基化终末产物(AGEs)、可溶性晚期糖基化终末产物受体(sRAGE)水平与脑梗死后出血性转化(HT)的相关性。方法选取2018-01—2019-12许昌市人民医院收治的91例ACI患者为研究对象,所有患者入院后均根据病情接受个性化治疗。观察ACI后HT发生情况并分组,检测并比较各组患者血清AGEs、sRAGE水平,分析血清AGEs、sRAGE水平与ACI后HT的相关性。结果91例ACI患者治疗后血清AGEs水平均较治疗前下降,sRAGE水平较治疗前升高(P<0.05)。91例患者中30例发生ACI后HT,发生率32.97%。转化组血清AGEs水平高于未转化组,sRAGE水平低于未转化组(P<0.05)。经双变量Pearson直线相关性检验显示,ACI患者血清AGEs与sRAGE之间呈负相关(r<0,P<0.05)。经Logistic回归分析显示,血清AGEs过表达、sRAGE低表达可能是ACI后HT的影响因素(OR>1,P<0.05)。绘制受试者工作曲线(ROC)显示,ACI患者治疗前血清AGEs、sRAGE水平预测HT的曲线下面积(AUC)分别为0.858、0.857,均有一定预测价值。结论ACI后患者血清AGEs普遍呈过表达,sRAGE呈低表达,其异常表达可能会增加HT风险,监测ACI患者入院时血清AGEs、sRAGE水平可能对早期预测患者HT风险有一定价值。

Objective To observe the level of serum advanced glycation end-products(AGEs)and soluble advanced glycation end-product receptors(sRAGE)in patients with acute cerebral infarction(ACI),and to analyze the correlation between various in⁃dexes and hemorrhagic transformation(HT)after cerebral infarction.Methods Totally 91 patients with ACI who were received by our hospital from January 2018 to December 2019 were selected as research subjects.The occurrence of HT after ACI and group was ob⁃served,the serum AGEs and sRAGE levels of patients were detected,and the correlation between serum AGEs and sRAGE levels and HT after ACI was analyzed.Results The level of serum AGEs in 91 patients with ACI after hospitalization for a period of time was lower than that before treatment,and the level of sRAGE was higher than before treatment(P<0.05);30 of 91 patients had hem⁃orrhagic after ACI,the incidence of conversion was 32.97%;the serum AGEs level of the transformed group was higher than that of the non-transformed group,and the sRAGE level was lower than that of the non-transformed group(P<0.05);the bivariate Pearson linear correlation test showed that the serum AGEs of patients with ACI has a negative correlation between sRAGE(r<0,P<0.05);Logistic regression analysis showed that over-expression of serum AGEs and low expression of sRAGE may be the influencing factors of HT after ACI(OR>1,P<0.05);the receiver operating curve(ROC)results showed that the area under the curve(AUC)of serum AGEs and sRAGE levels before treatment in patients with ACI to predict HT were 0.858,0.857,respectively,which both>0.85,and had certain prediction value.Conclusion After ACI,patients’serum AGEs are generally overexpressed and sRAGE is lowly ex⁃pressed.Abnormal expression of this serum index may increase the risk of HT.It is recommended to monitor the serum AGEs and sRAGE levels of patients with ACI when they are received by the hospital,which may have certain value for early prediction of pa⁃tients’HT risk.