新型金属蛋白酶ADAMTS家族在缺血性脑血管疾病中的诊断价值

Diagnostic value of novel metalloproteinase ADAMTS family in ischemic cerebral vascular disease

目的探究含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶(ADAMTS)家族在缺血性脑血管疾病(ICVD)中的诊断价值。方法选取本院ICVD患者104例为观察组[急性脑梗死(ACI)70例、短暂性脑缺血发作(TIA)34例],同期健康体检者52例为对照组。比较两组血清ADAMTS家族指标(ADAMTS-1、ADAMTS-4、ADAMTS-12、ADAMTS-13)水平,对比观察组ACI与TIA患者ADAMTS家族指标水平,以及与美国国立卫生院卒中量表(NIHSS)评分关系,分析其对ACI、TIA的鉴别诊断价值。结果观察组血清ADAMTS-1、ADAMTS-4、ADAMTS-12水平高于对照组,与NIHSS评分呈正相关(r=0.872、0.870、0.754),ADAMTS-13水平低于对照组与NIHSS评分呈负相关(r=-0.807),差异有统计学意义(P<0.05);血清ADAMTS家族各指标对ICVD的诊断AUC分别为0.797、0.785、0.829、0.732,联合诊断敏感度为86.54%、特异度为80.77%;观察组ACI与TIA患者血清ADAMTS-1、ADAMTS-4、ADAMTS-12、ADAMTS-13水平比较,差异有统计学意义(P<0.05);血清ADAMTS家族各指标联合鉴别诊断ACI、TIA的AUC最大为0.901,高于任一指标单独诊断。结论新型金属蛋白酶ADAMTS家族可作为ICVD高危人群筛选标志,对TIA、ACI鉴别诊断有较高应用价值。

Objective To explore the diagnostic value of a disintesrin and metalloprotease with thrombospondin type 1 motifs(ADAMTS)family in ischemic cerebral vascular disease(ICVD).Methods104 cases of ICVD patients in our hospital were selected as the observation group[70 cases of acute cerebral infarction(ACI),34 cases of transient ischemic attack(TIA)],and 52 cases of healthy physical examination during the same period were selected as the control group.The serum levels of ADAMTS family indicators(ADAMTS-1,ADAMTS-4,ADAMTS-12,and ADAMTS-13)were compared between the two groups.The ADAMTS family index levels of patients with ACI and TIA in the observation group were compared,and the relationship with the National Institutes of Health Stroke Scale(NIHSS)score was compared,and its value in the differential diagnosis of ACI and TIA was analyzed.Results The serum levels of ADAMTS-1,ADAMTS-4,and ADAMTS-12 in the observation group were higher than those in the control group,and were positively correlated with the NIHSS score(r=0.872,0.870,0.754).The ADAMTS-13 level lower than the control group was negatively correlated with the NIHSS score(r=-0.807),and the difference was statistically significant(P<0.05).The AUC of the serum ADAMTS family indicators for the diagnosis of ICVD were 0.797,0.785,0.829,0.732,respectively.The sensitivity of combined diagnosis was 86.54%and the specificity was80.77%.There were statistically significant differences in serum ADAMTS-1,ADAMTS-4,ADAMTS-12,and ADAMTS-13 levels between ACI and TIA patients in the observation group(P<0.05).The maximum AUC of the combined differential diagnosis of ACI and TIA by serum ADAMTS family indicators was 0.901,which was higher than any single indicator diagnosis.Conclusion The ADAMTS family of novel metalloproteinases can be used as screening markers for high-risk groups of ICVD,and has high application value in the differential diagnosis of TIA and ACI.