C型凝集素样受体2与急性脑梗死病情程度及脑动脉狭窄的相关性研究

Study on the correlation of CLEC-2 with the severity of acute cerebral infarction and cerebral artery stenosis

目的探讨血小板表面C型凝集素样受体2(C-type lectin-like receptor 2,CLEC-2)与急性脑梗死病情程度及脑动脉狭窄的相关性。方法前瞻性选取首次发病住院的211例急性脑梗死患者为梗死组,根据入院时NIHSS评分及头部MRA检查结果进行分组,并设105例健康体检者为对照组。所有患者入院当天采集静脉血进行CLEC-2检测,统计分析各组间CLEC-2水平。结果梗死组血浆CLEC-2水平较对照组明显升高(P<0.001),急性脑梗死轻、中、重亚组CLEC-2水平逐渐升高,两两比较差异有统计学意义(P<0.001)。调整混杂因素后,CLEC-2浓度(OR=1.034,95%CI 1.020~1.048,P<0.001)为急性脑梗死患者脑动脉狭窄的独立危险因素。受试者工作特征(ROC)曲线分析显示,CLEC-2预测脑动脉狭窄的曲线下面积为0.862(95%CI 0.812~0.912,P<0.001);最佳截断值为266.40 pg/ml,预测脑动脉狭窄的敏感度为80.3%,特异度为80.9%。结论CLEC-2水平升高能评估急性脑梗死患者病情程度,是脑动脉狭窄独立危险因素,对预测脑动脉狭窄有一定价值。

Objective To explore the relationship between C-type lectin-like receptor 2(CLEC-2)on platelet surface and the severity of acute cerebral infarction and cerebral artery stenosis.Methods Prospectively selected 211 patients with acute cerebral infarction who were hospitalized for the first time as the infarction group,the patients were grouped according to the NIHSS score and cranial MRA examination results on admission,and 105 healthy patients were collected as the control group.Venous blood of all patients was collected for CLEC-2 detection on the day of admission,and the level of CLEC-2 between each group was analyzed.Results The level of plasma CLEC-2 in the infarction group was significantly higher than that in the control group(P<0.001).The level of CLEC-2 in the mild,moderate and severe acute cerebral infarction subgroups gradually increased,and the difference between the two groups was statistically significant(P<0.001).After adjusting for confounding factors,the concentration of CLEC-2(OR=1.034,95%CI1.020~1.048,P<0.001)was an independent risk factor for cerebral artery stenosis in patients with acute cerebral infarction.Receiver operating characteristic(ROC)curve analysis showed that the area under the curve for CLEC-2 to predict cerebral artery stenosis was 0.862(95%CI 0.812~0.912,P<0.001);the best cut-off value was 266.40pg/ml,predicted the sensitivity of cerebral artery stenosis was 80.3%,and the specificity was 80.9%.Conclusion Elevated levels of CLEC-2 can assess the severity of ACI patients,is an independent risk factor for cerebral artery stenosis,and has certain value in predicting cerebral artery stenosis.