AIS患者血清视黄醇结合蛋白4、8-异前列腺素水平与疾病严重程度及预后的关系

Relationship between serum retinol binding protein 4,8-isoprostaglandin levels and disease severity and prognosis in patients with acute ischemic stroke

目的探讨急性缺血性脑卒中(AIS)患者血清视黄醇结合蛋白4(RBP4)、8-异前列腺素(8-iso-PGF2α)水平与疾病严重程度及预后的关系,分析RBP4、8-iso-PGF2α对AIS患者预后的预测价值。方法选取2020年08月至2021年06月承德医学院附属医院神经内科发病72 h内的AIS患者176例作为研究对象,另选取同期健康体检者40例作为对照组。采用酶联免疫法检测患者血清RBP4、8-iso-PGF2α水平,按照美国国立卫生研究院卒中量表(NIHSS)评分将AIS患者分为轻度组、中度组、重度组,根据AIS患者持续治疗14d后采用改良Rankin量表(MRS)评分将患者分为预后良好组、预后不良组。Pearson相关性分析血清RBP4、8-iso-PGF2α水平与NIHSS评分及MRS评分的相关性,受试者工作特征曲线(ROC)分析RBP4、8-iso-PGF2α预测AIS患者预后的价值。结果AIS患者血清RBP4、8-iso-PGF2α水平高于对照组(P<0.05)。重度组血清RBP4、8-iso-PGF2α水平高于中、轻度组(P<0.05),中度组血清RBP4水平高于轻度组(P<0.05)。预后不良组血清RBP4、8-iso-PGF2α水平高于预后良好组(P=0.000)。AIS患者血清RBP4、8-iso-PG F2α水平与NIHSS评分、MRS评分呈正相关(rs=0.627、0.598;0.605、0.529,P=0.000)。RBP4、8-iso-PGF2α、联合RBP4和8-iso-PGF2α预测AIS患者预后的曲线下面积(AUC)分别为0.845、0.812、0.908。结论AIS患者血清RBP4、8-iso-PGF2α水平升高。高水平的RBP4、8-iso-PGF2α与AIS患者疾病严重程度及不良预后均有关。RBP4、8-iso-PGF2α水平对AIS患者的预后具有一定的预测价值,两项指标联合可以提高其预测价值。

Objective To investigate the relationship between the level of serum retinol binding protein4(RBP4),8-iso-prostaglandin-F2 alpha(8-iso-PGF2α)and the severity and prognosis in patients with acute ischemic stroke(AIS),and to analyze the predictive value of RBP4 and 8-iso-PGF2αfor prognosis in AIS.Methods From August 2020 to June 2021,one hundred and seventy-six patients with AIS in the Department of Neurology of the Affiliated Hospital of Chengde Medical College were selected as the study subjects,and 40 healthy subjects were selected as the control group.Serum RBP4 and 8-iso-PGF2 a levels were detected by enzyme-linked immunoassay(ELISA).According to The National Institute of Health Stroke Scale(NIHSS),patients with AIS were divided into mild group,moderate group and severe group,according to The Modified Rankin Scale(MRS)after 14 days of treatment,the patients with AIS were divided into good prognosis group and poor prognosis group.Pearson correlation analysis was used to analyze the correlation between serum RBP4,8-iso-PGF2αlevels and NIHSS score and MRS score in AIS patients,and Receiver Operating Characteristic(ROC)curve was used to analyze the value of RBP4 and 8-isoPGF2αin predicting the prognosis of AIS patients.Results The level of RBP4 and 8-iso-PGF2αin patients with AIS was higher than that in control group(P<0.05).The level of RBP4 and 8-iso-PGF2αin severe patients was higher than that in moderate and mild patients(P<0.05),and the level of RBP4 in moderate patients was higher than that in mild patients(P<0.05).The level of RBP4 and 8-iso-PGF2αin poor prognosis group was higher than that in good prognosis group(P=0.000).Pearson correlation analysis showed that serum RBP4 and 8-iso-PGF2αlevels in AIS patients were positively correlated with NIHSS and MRS scores(rs=0.627,0.598;0.605,0.529,P=0.000).ROC analysis showed that the area under the curve(AUC)of RBP4、8-iso-PGF2α、combined RBP4 and 8-iso-PGF2αto predict the prognosis of AIS patients was 0.845,0.812,0.908.Conclusion The levels of RBP4 and 8-iso-PGF2αin serum of AIS patients were elevated.The high levels of RBP4 and 8-iso-PGF2αwere associated with the severity and poor prognosis of AIS patients.RBP4 and 8-iso-PGF2αlevels have certain predictive value for the prognosis of AIS patients,and the combination of the two indicators can improve the predictive value.