氧化应激指标与缺血性脑卒中继发出血转化的关系及对癫痫发病的预测研究

The Relationship Between Oxidative Stress Index and Ischemic Stroke Secondary Bleeding Transformation and the Prediction of Epilepsy

目的:探讨氧化应激指标与缺血性脑卒中继发出血转化的关系及对癫痫发病的预测研究。方法:选择黑龙江省佳木斯市中心医院2016年1月-2020年10月接诊的365例缺血性脑卒中患者作为观察组,另选同期的100例健康体检者作为对照组;根据缺血性脑卒中患者是否继发出血转化,分为出血组和正常组;比较观察组与对照组血清氧化应激指标[丙二醛(MDA)、8-羟基脱氧鸟苷酸(8-OHdG)和谷胱甘肽过氧化物酶(GSH-Px)]水平,使用单因素及多因素logistic回归分析血清氧化应激指标与缺血性脑卒中继发出血转化的关系,分析癫痫发病情况,通过受试者工作特征(ROC)曲线下面积(AUC)评价氧化应激指标对癫痫发病的预测效能。结果:观察组血清MDA、8-OHdG水平均明显高于对照组,GSH-Px水平明显低于对照组,差异均有统计学意义(P<0.05);出血转化组血清MDA、8-OHdG水平均明显高于正常组,GSH-Px水平明显低于正常组,差异均有统计学意义(P<0.05);经多因素logistic回归分析显示,血清MDA>7.34 ng/mL、8-OHdG>18.12 ng/mL均为缺血性脑卒中继发出血转化的独立危险因素(P<0.05),GSH-Px>244.37 ng/mL是保护性因素(P<0.05);经ROC曲线分析,血清MDA、8-OHdG联合GSH-Px预测癫痫发病的AUC为0.916。结论:血清MDA、8-OHdG、GSH-Px水平均与缺血性脑卒中继发出血转化密切相关,三者联合预测癫痫发病的效能较高,值得临床检测中应用。

Objective:To explore the relationship between oxidative stress index and the transformation of ischemic stroke secondary bleeding and to predict the incidence of epilepsy.Method:365 patients with ischemic stroke admitted to Jiamusi Central Hospital,Heilongjiang Province from January 2016 to October 2020 were selected as the observation group,and 100 healthy physical examination patients in the same period were selected as the control group.Patients with ischemic stroke were divided into bleeding group and normal group according to whether they had secondary bleeding transformation.The levels of serum oxidative stress indexes[malondialdehyde (MDA),8-hydroxydeoxyguanosine acid (8-OHdG) and glutathione peroxidase (GSH-Px)]were compared between the observation group and the control group.Univariate and multivariate logistic regression were used to analyze the relationship between serum oxidative stress indexes and the transformation of secondary bleeding after ischemic stroke.The incidence of epilepsy was analyzed.The area under ROC curve (AUC) was used to evaluate the predictive efficacy of oxidative stress on the incidence of epilepsy.Result:The levels of serum MDA,8-OHdG in the observation group were significantly higher than those in the control group,and level of GSH-Px was significantly lower than that in the control group,with statistically significant differences (P<0.05).The levels of serum MDA,8-OHdG were significantly higher in the hemorrhagic transformation group than those in the normal group,and level of GSH-Px was significantly lower than that in the normal group,with statistically significant differences (P<0.05).Multivariate logistic regression analysis showed that serum MDA>7.34 ng/mL,8-OHdG>18.12 ng/mL were independent risk factors for secondary hemorrhagic transformation of ischemic stroke (P<0.05),and GSH-Px >244.37 ng/mLwas a protective factor (P<0.05).By ROC curve analysis,the AUC of serum MDA and 8-OHdG combined with GSH-Px in predicting the onset of epilepsy was 0.916.Conclusion:The levels of serum MDA,8-OHdG and GSH-Pxare closely related to the secondary bleeding transformation of ischemic strok.The combination of the three has high efficacy in predicting the onset of epilepsy,and it is worthy of application in clinical testing.