急性缺血性脑卒中患者侧支循环与血清SAA表达的相关性

Correlation between collateral circulation and serum SAA expression in patients with acute ischemic stroke

【目的】探讨急性缺血性脑卒中(acute ischemic stroke,AIS)患者入院时血清淀粉样蛋白A(serum amyloid A protein,SAA)水平,分析其与AIS患者脑侧支循环的关系。【方法】选取2016年1月至2020年1月本院诊治的AIS患者108例为研究对象,按照脑侧支循环检查结果分为侧支循环不良组39例,侧支循环良好组69例;根据患者的美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分标准,将AIS患者分为神经功能障碍轻度组19例、中度组42例及重度组47例;并选取同期体检结果健康者108例为对照组。采用酶联免疫吸附(enzyme-linked immunosorbent assay,ELISA)法检测血清中SAA水平,采用受试者工作特征(Receiver OperatingCharacteristic,ROC)曲线分析血清SAA水平对AIS患者侧支循环不良的诊断价值,用二元Logistic法对AIS患者侧支循环不良的相关因素进行分析。【结果】与对照组相比,侧支循环良好组、侧支循环不良组患者血清SAA水平较高(P<0.05),与侧支循环良好组相比,侧支循环不良组患者入院时NIHSS评分、大面积脑梗死例数比、血清SAA水平较高(P<0.05);与轻度组相比,中度组、重度组患者血清SAA水平较高(P<0.05),与中度组相比,重度组患者血清SAA水平较高(P<0.05);血清SAA水平预测AIS侧支循环不良的ROC曲线下面的面积为0.809(95%CI为0.723~0.895),灵敏度为69.20%,特异度为82.60%。二元Logistic回归分析显示高NIHSS评分、血清SAA高水平是影响AIS患者侧支循环不良的危险因素。【结论】AIS患者血清SAA水平上调,其水平上调对诊断AIS患者侧支循环不良有一定价值。

【Objective】To investigate the level of serum amyloid A protein(SAA)in patients with acute ischemic stroke(AIS)at admission,and analyze the relationship between SAA and cerebral collateral circulation.【Methods】A total of 108 AIS patients from January 2016 to January 2020 in our hospital were selected as the research objects,according to the results of cerebral collateral circulation examination,the patients were divided into poor collateral circulation group(39 cases)and good collateral circulation group(69 cases);according to NIHSS score,AIS patients were divided into mild group(n=19),moderate group(n=42)and severe group(n=47);meanwhile,108 healthy people were selected as the control group.The level of serum SAA was detected by enzyme-linked immunosorbent assay(ELISA),receiver operating curve(ROC)was used to analyze the diagnostic value of serum SAA level for poor collateral circulation in patients with AIS,and binary Logistic method was used to analyze the related factors of poor collateral circulation in AIS patients.【Results】Compared with those in the control group,the level of serum SAA in the good collateral circulation group and the poor collateral circulation group was higher(P<0.05),compared with those in the good collateral circulation group,the NIHSS score at admission,the ratio of patients with massive cerebral infarction and the level of serum SAA in the poor collateral circulation group were higher(P<0.05);compared with that in mild group,the level of serum SAA in moderate group and severe group was higher(P<0.05),compared with that in moderate group,the level of serum SAA in severe group was higher(P<0.05);the area under ROC curve of serum SAA level in predicting AIS poor collateral circulation was 0.809(95%CI:0.723-0.895),the sensitivity was 69.20%,and the specificity was 82.60%.Binary Logistic regression analysis showed that high NIHSS score and high serum SAA level were risk factors for poor collateral circulation in AIS patients.【Conclusion】The serum SAA level is up-regulated in AIS patients,and it is valuable for the diagnosis of poor collateral circulation in AIS patients.