血清视锥蛋白样蛋白1和CXC型趋化因子配体16及抗心磷脂抗体水平与急性脑梗死患者病情及预后的关系研究

Relationship of Serum Levels of Visinin-likeprotein-1,CXC Chemokine Ligand 16 and Anticardiolipin Antibody with the Severity and Prognosis in Patients with Acute Cerebral Infarction

背景急性脑梗死属于脑血管常见病症,严重威胁人们健康。目前,国内外均有研究显示血清检验指标在脑损伤评估中表现良好,但仍需进一步探寻高特异性与高准确性指标,为诊断急性脑梗死病情进展及预后研究提供新思路。目的探讨血清视锥蛋白样蛋白1(VILIP-1)、CXC型趋化因子配体16(CXCL16)及抗心磷脂抗体(ACA)水平与急性脑梗死患者病情及预后的相关性。方法选取2019年6月-2020年8月杭州市富阳区第一人民医院收治的急性脑梗死患者(急性脑梗死组,n=116),以及同期在本院健康体检者(对照组,n=60)作为研究对象。急性脑梗死组患者根据神经功能损伤程度分为轻、中、重度损伤亚组(n=36、48、32),根据颅脑电子计算机断层扫描(CT)检查的脑梗死面积分为大、中、小面积梗死亚组(n=30、55、31),根据改良Rankin量表(mRS)分为预后良好、预后不良亚组(n=70、46)。比较对照组、急性脑梗死组及各亚组血清VILIP-1、CXCL16、ACA水平,绘制血清VILIP-1、CXCL16、ACA预测急性脑梗死预后的受试者工作特征(ROC)曲线。结果急性脑梗死组血清VILIP-1、CXCL16、ACA水平高于对照组(P<0.0.5)。中、重度损伤亚组血清VILIP-1、CXCL16、ACA水平高于轻度损伤亚组,重度损伤亚组血清VILIP-1、CXCL16、ACA水平高于中度损伤亚组(P<0.05)。中、大面积梗死亚组血清VILIP-1、CXCL16、ACA水平高于小面积梗死亚组,大面积梗死亚组血清VILIP-1、CXCL16、ACA水平高于中面积梗死亚组(P<0.05)。预后不良亚组血清VILIP-1、CXCL16、ACA水平高于预后良好亚组(P<0.0.5)。血清VILIP-1、CXCL16、ACA预测急性脑梗死预后的ROC曲线下面积(AUC)分别为0.848、0.820、0.784,灵敏度分别为82.61%、89.13%、73.91%,特异度分别为75.71%、64.29%、71.43%。结论急性脑梗死患者血清VILIP-1、CXCL16及ACA水平较健康人群明显上升,且各指标的表达与脑梗死损伤程度分型及临床预后密切相关,可作为预测急性脑梗死预后情况的指标。

Background Acute cerebral infarction is a common clinical cerebrovascular disease that seriously threatens human life.Studies have shown serum test indicators have good accuracy in assessing brain injury,but it is necessary to find indicators with higher specificity and accuracy,providing insights into the prediction of the progression and prognosis of acute cerebral infarction.Objective To explore the relationship of serum levels of visinin-like protein-1(VILIP-1),CXC chemokine ligand 16(CXCL16)and anticardiolipin antibody(ACA)levels with the severity and prognosis in patients with acute cerebral infarction.Methods Patients with acute cerebral infarction(n=116)and healthy examinees(n=60)were selected from the First People's Hospital of Fuyang District,Hangzhou from June 2019 to August 2020.Serum levels of VILIP-1,CXCL16 and ACA were compared between acute cerebral infarction patients and healthy examinees,and between subgroups of acute cerebral infarction patients divided by degree of neurological impairment〔mild subgroup(n=36),moderate subgroup(n=48)and severe subgroup(n=32)〕,head CT-detected infarction size〔small infarction subgroup(n=31),medium infarction subgroup(n=55),and large infarction subgroup(n=30)〕,and prognosis assessed by the modified Rankin Scale〔good prognosis subgroup(n=70),poor prognosis subgroup(n=46)〕.The ROC curve of the serum VILIP-1,CXCL16 and ACA was plotted to examine the prognostic value of each of them for acute cerebral infarction.Results Acute cerebral infarction patients had significantly higher levels of VILIP-1,CXCL16 and ACA than the healthy examinees(P<0.05).The levels of VILIP-1,CXCL16 and ACA showed a significant increase successively across mild,moderate and severe subgroups(P<0.05).The level of these three parameters also demonstrated a notable increase successively across small,intermediate and large infarction subgroups(P<0.05).Furthermore,they were much higher in poor prognosis subgroup than those in good prognosis subgroup(P<0.05).The AUC of serum VILIP-1 for predicting the prognosis of acute cerebral infarction was 0.848,with 82.61%sensitivity,and 75.71%specificity.The AUC of serum CXCL16 was 0.820,with 89.13%sensitivity,and 64.29%specificity.The AUC of serum ACA was 0.784,with 73.91%sensitivity,and 71.43%specificity.Conclusion Elevated VILIP-1,CXCL16 and ACA were found in patients with acute cerebral infarction,whose expression levels were closely related to the degree of cerebral infarction and clinical prognosis,so they may be used as prognostic indicators for acute cerebral infarction.