血清YKL-40及sLOX-1水平与急性缺血性脑梗死患者短期预后的相关性研究

A Correlation Study of Serum YKL-40 and sLOX-1 Levels and Short-Term Prognosis of Patients with Acute Ischemic Cerebral Infarction

目的探讨血清甲壳质酶蛋白-40(YKL-40)及可溶性凝集素样氧化型低密度脂蛋白受体-1(sLOX-1)水平与急性缺血性脑梗死患者短期预后的相关性。方法收集2017年6月至2020年6月我院诊治的急性缺血性脑梗死患者168例,依据患者脑梗死体积分为大梗死组(n=36)、中梗死组(n=77)、小梗死组(n=55),依据患者神经功能缺损程度分为轻度组(n=36)、中度组(n=70)、重度组(n=62),依据患者发病后3个月预后不同分为死亡组(n=17)、未死亡组(n=151)。比较各组一般资料和血清YKL-40、sLOX-1水平,并对急性缺血性脑梗死患者血清YKL-40、sLOX-1水平与短期预后的关系进行相关性分析。结果大梗死组血清YKL-40、sLOX-1水平较中梗死组、小梗死组明显升高,神经功能缺损程度较中梗死组和小梗死组明显加重(P<0.05),而中梗死组较小梗死组亦明显加重(P<0.05)。重度组、中度组、轻度组血清YKL-40、sLOX-1水平依次明显降低,组间两两比较差异有统计学意义(P<0.05)。死亡组脑梗死体积、神经功能损伤程度、血清YKL-40、sLOX-1水平较未死亡组明显提高(P<0.05);脑梗死体积、神经功能受损程度、YKL-40、sLOX-1是急性缺血性脑梗死患者短期预后的危险因素(P<0.05)。Spearman参数相关性分析提示血清YKL-40、sLOX-1水平与急性缺血性脑梗死短期随访死亡率呈明显的正相关(r=0.613、0.592,P<0.05)。结论急性缺血性脑梗死患者血清YKL-40及sLOX-1水平呈明显增高趋势,其表达水平与急性缺血性脑梗死患者短期预后存在明显的相关性,可作为急性缺血性脑梗死患者短期预后评估的有效标志物。

Objective The current study aims to explore the correlation between serum chitin enzymes protein-40(YKL-40)and soluble lectin-like oxidized low-density lipoprotein receptor-1(sLOX-1)levels and the short-term prognosis of patients with acute ischemic cerebral infarction.Methods Between June,2017 and June,2020,168 patients with acute ischemic cerebral infarction were enrolled in this study.All subjects were divided into the large infarction group(n=36),medium infarction group(n=77),and small infarction group(n=55),according to the cerebral infarction volume,and were also divided into the mild group(n=36),moderate group(n=70),and severe group(n=62),according to the degree of neurological impairment,and were divided into the death group(n=17)and non-death group(n=151),according to the prognosis in 3 months after onset.General data and serum YKL-40 and sLOX-1 levels were compared among these groups,and a correlation analysis of serum YKL-40 and sLOX-1 levels and short-term prognosis of ACI patients was performed.Results Serum YKL-40 and sLOX-1 levels were significantly higher,and neurological impairment was significantly severer in the large infarction group than those in the medium and small infarction groups(P<0.05),and the same was observed in the medium infarction group than in the small infarction group(P<0.05).Serum YKL-40 and sLOX-1 levels in the severe group,moderate group,and mild group significantly decreased in sequence,with statistically significant differences between any two groups(P<0.05).The cerebral infarction area,the degree of neurological impairment,serum YKL-40 and sLOX-1 levels were all significantly larger or higher in the death group than those in the non-death group(P<0.05).The cerebral infarction area,the degree of neurological impairment,YKL-40 and sLOX-1 were influencing factors of short-term prognosis of ACI patients(P<0.05).Spearman correlation analysis indicated that serum YKL-40 and sLOX-1 levels were significantly positively correlated with the short-term follow-up mortality of ACI patients(r=0.613,0.592,P<0.05).Conclusion Patients with acute ischemic cerebral infarction have significantly elevated serum YKL-40 and sLOX-1 levels which are significantly correlated with the short-term prognosis,suggesting that these factors could be used as effective markers for the short-term prognosis of ACI patients.