血清VE-Cad、ENA-78和HMGB1水平检测在急性脑梗死中的临床价值

Clinical value of serum VE-Cad,ENA-78 and HMGB1 levels in acute cerebral infarction

目的探讨血清血管内皮细胞钙黏蛋白(VE-Cad)、中性粒细胞激活肽-78(ENA-78)和高迁移率族蛋白B1(HMGB1)水平检测在急性脑梗死(ACI)患者中的临床价值。方法选择2019年1月至2020年6月在该院诊治的117例ACI患者作为ACI组,另选同期该院45例体检健康者作为对照组。检测所有研究对象的血清VE-Cad、ENA-78和HMGB1水平,比较ACI组和对照组及不同梗死面积、不同神经功能缺损程度、不同预后的ACI患者血清VE-Cad、ENA-78和HMGB1水平,采用Pearson相关分析3项指标间的相关性,应用受试者工作特征(ROC)曲线分析3项指标对ACI不良预后的预测效能。结果ACI组的血清VE-Cad、ENA-78和HMGB1水平高于对照组(P<0.05)。VE-Cad、ENA-78和HMGB1水平随着脑梗死面积的增大和神经功能缺损程度的增加而升高,其水平越高,ACI患者预后越差(P<0.05)。ACI患者血清VE-Cad水平与ENA-78、HMGB1呈正相关(r=0.685、0.813,P<0.05),ENA-78水平与HMGB1也呈正相关(r=0.739,P<0.05)。血清VE-Cad、ENA-78和HMGB1对ACI不良预后具有较高的预测效能,3项联合检测预测ACI不良预后的曲线下面积为0.972,高于VE-Cad、ENA-78和HMGB1单独检测的0.898、0.861、0.851(P<0.05)。结论血清VE-Cad、ENA-78和HMGB1水平与ACI的病情严重程度和不良预后有关,三者联合检测有助于判断ACI的预后。

Objective To investigate the clinical value of serum vascular endothelial cadherin(VE-Cad),epithelia neutrophil activating peptide-78(ENA-78)and high mobility group protein B1(HMGB1)in patients with acute cerebral infarction(ACI).Methods A total of 117 ACI patients who were diagnosed and treated in the hospital from January 2019 to June 2020 were selected as the ACI group,and 45 healthy people who underwent a physical examination in the hospital during the same period were selected as the control group.The serum VE-Cad,ENA-78 and HMGB1 levels of all subjects were detected,and the serum VE-Cad,ENA-78 and HMGB1 levels of ACI with different infarct sizes,different neurological deficits and different prognosis were compared between the ACI group and the control group.Pearson correlation was used to analyze the correlation among the three indicators,and receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of the three indicators for the poor prognosis of ACI.Results The levels of serum VE-Cad,ENA-78 and HMGB1 in the ACI group were higher than those in the control group(P<0.05).The levels of VE-Cad,ENA-78 and HMGB1 increased with the increase of cerebral infarction area and neurological impairment,the higher the level,the worse the prognosis of ACI patients(P<0.05).The levels of serum VE-Cad were positively correlated with ENA-78 and HMGB1(r=0.685,0.813,P<0.05),and the level of ENA-78 were also positively correlated with HMGB1(r=0.739,P<0.05).Serum VE-Cad,ENA-78 and HMGB1 had high predictive power for poor prognosis of ACI.The area under the ROC curve of the three combined detection to predict poor prognosis of ACI was 0.972,which was higher than that of 0.898,0.861 and 0.851 of VE-Cad,ENA-78 and HMGB1 alone(P<0.05).Conclusion The serum levels of VE-Cad,ENA-78 and HMGB1 are related to the severity and poor prognosis of cerebral infarction,and the combined detection of the three is helpful to judge the prognosis of ACI.