S-100β和t-PA在急性脑梗死中的表达及预后评估价值

Expressions of S-100βand t-PA in acute cerebral infarction and its prognostic evaluation value

目的研究S-100β、组织型纤溶酶原激活剂(t-PA)在急性脑梗死中的表达及预后评估价值。方法回顾性选取2018年3月至2020年3月南通大学附属如皋医院收治的72例急性脑梗死患者作为实验组,并选取70例同期健康体检者作为对照组。实验组患者接受常规治疗,并在患者出院以后展开围期6个月的随访,根据格拉斯哥预后评分(GOS)将研究对象分为预后不良组(n=31,GOS评分1~3分)和预后较好组(n=41,GOS评分4~5分)。比较实验组和对照组患者血清S-100β、t-PA水平,对比预后不良组和预后较好组血清S-100β、t-PA水平和一般资料,并分析其对患者预后预测的临床意义。结果实验组S-100β为(0.98±0.11)μg/L,显著高于对照组[(0.42±0.11)μg/L],t-PA为(15.42±1.41)ng/mL,显著低于对照组[(20.09±1.08)ng/mL],差异均有统计学意义(P<0.05)。预后不良组患者血清S-100β为(0.63±0.18)μg/L,显著高于预后良好组[(1.14±0.11)μg/L],t-PA为(16.56±1.89)ng/mL,显著低于预后良好组[(13.09±1.13)ng/mL],差异均有统计学意义(P<0.05)。预后不良组患者年龄≥65岁、高血压、糖尿病、高血脂的患者比率显著高于预后较好组,发病到治疗时间、C反应蛋白(CRP)水平显著高于显著预后较好组,差异均有统计学意义(P<0.05)。通过受试者工作特征曲线得出:血清S-100β、t-PA、发病到治疗时间和CRP预测急性脑梗死预后的敏感度、特异度均较高。结论急性脑梗死患者血清血清S-100β明显升高,t-PA明显降低,并且预后越差患者血清S-100β明显更高,t-PA明显更低;血清S-100β、t-PA、年龄、发病到治疗时间以及CRP在患者的预后评估中具有重要的价值。

Objective To study the expressions of S-100βand tissue-type plasminogen activator(t-PA)in acute cerebral infarction and its prognostic evaluation value.Methods Seventy-two patients with acute cerebral infarction admitted to our hospital from March 2018 to March 2020 were retrospectively selected as the experimental group,and 70 physically healthy patients during the same period were as the control group.All patients in the experimental group received conventional treatment and were followed up for 6 months after discharge.According to the Glasgow Outcome Score(GOS),they were divided into poor prognosis group(n=31,GOS score 1-3)and good prognosis group(n=41,GOS score 4-5).The levels of serum S-100βand t-PA between the experimental group and the control group were compared.General data,levels of serum S-100βand t-PA between the poor prognosis group and the better prognosis group were compared.Its clinical significance in predicting the prognosis of patients was analyzed.Results The level of S-100βin the experimental group was(0.98±0.11)μg/L,which was significantly higher than that in the control group[(0.42±0.11)μg/L],and the level of t-PA was(15.42±1.41)ng/mL,which was significantly lower than that in the control group[(20.09±1.08)ng/mL],the differences were statistically significant(P<0.05).The level serum S-100β(0.63±0.18)μg/L in the poor prognosis group was significantly higher than that in the good prognosis group[(1.14±0.11)μg/L],and the level of t-PA was(16.56±1.89)ng/mL,which was significantly lower than that in the good prognosis group[(13.09±1.13)ng/mL],the differences were statistically significant(P<0.05).The rate of patients in the poor prognosis group aged≥65 years,hypertension,diabetes,and hyperlipidemia were significantly higher than those in the good prognosis group,the time from onset to treatment and the level of C-reactive protein were significantly higher than those in the significantly good prognosis group,and the differences were statistically significant(P<0.05).The receiver operating characteristic curve showed that serum S-100β,t-PA,the time from onset to treatment and CRP had high sensitivity and specificity for the prognosis of acute cerebral infarction.Conclusion Serum S-100βsignificantly increased,and t-PA decreased significantly in patients with acute cerebral infarction.The worse the prognosis,the significantly higher the serum S-100β,and the significantly lower the t-PA;serum S-100β,t-PA,age,time from onset to treatment,and CRP have important values in the prognostic evaluation of patients.