急性缺血性脑卒中患者血清Occludin表达水平及其临床意义

Serum Occludin Expression Levels in Patients with Acute IschemicStroke and Its Clinical Significance

目的探讨急性缺血性脑卒中(AIS)患者血清闭合蛋白(Occludin)表达水平及其临床意义。方法选取我院2019年1月至2020年12月收治的207例AIS患者为AIS组,另选取同期68例体检健康者为对照组。收集患者临床资料,酶联免疫吸附法测定血清Occludin水平。比较不同病情严重程度AIS患者血清Occludin水平,Spearman相关性分析AIS患者血清Occludin水平与NIHSS评分的相关性。分析血清Occludin水平与出血转化的关系,多因素Logistics回归分析AIS患者预后不良影响因素,ROC曲线分析血清Occludin水平与AIS发生、出血转化、预后的关系。结果AIS组血清Occludin水平明显高于对照组(P<0.05)。重度缺损组血清Occludin水平明显高于中、轻度缺损组,中度缺损组血清Occludin水平明显高于轻度缺损组(P<0.05)。血清Occludin水平与NIHSS评分呈正相关(r s=0.512,P<0.05)。出血转化组血清Occludin水平明显高于非出血转化组(P<0.05)。高血清Occludin水平(OR=2.121,95%CI:1.457~3.086)为AIS患者预后不良独立危险因素(P<0.05)。血清Occludin水平预测AIS发生、出血转化、预后不良的曲线下面积为0.856、0.770、0.857。结论AIS患者血清水平明显升高,与病情严重程度密切相关,可作为AIS发生、出血转化、预后不良的预测指标。

Objective To investigate the expression level of serum Occludin in patients with acute ischemic stroke(AIS)and its clinical significance.Methods A total of 207 patients with AIS admitted to our hospital(January,2019 to December,2020)were selected as the AIS group,while another 68 physically healthy individuals were selected as the control group during the same period.Clinical data were collected from all patients and serum Occludin levels were measured by ELISA.Serum Occludin levels in patients with AIS of different severities were compared,and the correlation between serum Occludin levels and NIHSS scores in patients with AIS was analyzed by Spearman correlation.The relationship between serum Occludin levels and hemorrhagic transformation was also analyzed,and the factors influencing poor prognosis in AIS patients were identified by multifactor logistic regression.The relationships between serum Occludin levels and the occurrence,hemorrhagic transformation and prognosis of AIS were evaluated by ROC curves.Results Serum Occludin levels in the AIS group were significantly higher than those in the control group(P<0.05).Serum Occludin levels were significantly higher in the severe deficiency group than in the moderate and mild deficiency groups,and serum Occludin levels were significantly higher in the moderate deficiency group than in the mild deficiency group(P<0.05).Serum Occludin levels were positively correlated with NIHSS scores(r s=0.512,P<0.05).Serum Occludin levels were significantly higher in the hemorrhage conversion group than in the non-hemorrhage conversion group(P<0.05).High serum Occludin levels(OR=2.121,95%CI:1.457 to 3.086)were an independent risk factor for the poor prognosis in patients with AIS(P<0.05).The areas under the curve for serum Occludin levels predicting AIS occurrence,bleeding conversion,and poor prognosis were 0.856,0.770,and 0.857,respectively.Conclusion A significantly elevated serum level in patients with AIS is correlate closely with the severity of the disease and can be used as a predictor of AIS occurrence,hemorrhagic transformation and poor prognosis.