CXCL-16及Galectin-3与急性脑梗死患者神经功能缺损程度及预后的关系

Relationship between CXCL-16 and Galectin-3 and the degree of neurological deficit and prognosis in patients with acute cerebral infarction

目的探讨趋化因子CXCL-16(ChemokineCXCL-16)、半乳糖凝集素-3(Galectin-3)与急性脑梗死(Acutecerebralinfarction,ACI)患者神经功能缺损程度及预后的关系。方法回顾性分析2019年3月—2021年3月河北北方学院附属第一医院老年病科收治的106例ACI患者的临床资料,根据入院时美国国立卫生研究院卒中量表(NIHSS)评分将患者分为轻度组(NIHSS评分<8分,n=37)、中度组(8分≤NIHSS评分≤16分,n=42)和重度组(NIHSS评分>16分,n=27)。改良Rankin量表(mRS)评分将随访90 d的患者分为预后良好组(mRS评分≤2分,n=76)和预后不良组(mRS评分>2分,n=30)。收集并比较患者一般资料。酶联免疫吸附法(ELISA)检测两组患者血清CXCL-16、Galectin-3水平;多因素Logistic回归分析影响ACI患者预后不良的危险因素;绘制受试者工作特征曲线(ROC)评价血清CXCL-16及Galectin-3水平对ACI患者预后不良的预测价值。结果中度和重度组患者血清Galectin-3、CXCL-16水平较轻度组升高,重度组患者较中度组升高(P<0.05)。与预后良好组比较,预后不良组患者血清Galectin-3、CXCL-16、NIHSS评分、低密度脂蛋白(LDL-C)水平升高,颈动脉中层厚度≥1.2 mm者增多(P<0.05)。血清CXCL-16、Galectin-3、NIHSS评分、LDL-C水平升高、颈动脉中层厚度≥1.2 mm是ACI患者预后不良的危险因素(P<0.05)。血清CXCL-16、Galectin-3水平预测ACI患者预后不良的曲线下面积(AUC)分别为0.833、0.798,敏感度分别为71.13%、70.13%,特异度分别为83.38%、85.20%,二者联合预测ACI患者预后不良的AUC为0.909,其敏感度、特异度分别为87.96%、82.38%。结论血清CXCL-16、Galectin-3水平变化可反映ACI患者神经功能缺损程度,且二者联合检测可提高对ACI患者预后的预测价值,为临床监测病情进展以及早干预,改善预后提供理论依据。

Objective To explore the relationship between chemokine CXCL-16,Galectin-3 and the degree of neurolog⁃ical deficit and prognosis in patients with acute cerebral infarction(ACI).Methods The clinical data of 106 ACI pa⁃tients admitted to the Department of Geriatrics of the First Affiliated Hospital of Hebei Northern University from March 2019 to March 2021 were retrospectively analyzed.According to the score of National Institutes of Healh Stroke Scale(NIHSS)at admission,the patients were divided into mild group(NIHSS score<8,n=37),moderate group(8≤NI⁃HSS score≤16,n=42)and severe group(NIHSS score>16,n=27).According to the modified Rankin Scale(mRS)score at admission,the patients following up for 90 days were divided into good prognosis group(mRS score≤2,n=76)and poor prognosis group(mRS score>2,n=30).The general data of patients were collected and compared.The serum lev⁃els of CXCL-16 and Galectin-3 were detected by enzyme-linked immunosorbent assay(ELISA).Multivariate logistic regression was used to analyze the risk factors affecting the poor prognosis of ACI patients.The receiver operating char⁃acteristic(ROC)curve was drawn to evaluate the predictive power of serum CXCL-16 and Galectin-3 levels in pa⁃tients with ACI.Results The levels of serum Galectin-3 and CXCL-16 in moderate and severe group were higher than those in mild group,and those in severe group were higher than those in moderate group(P<0.05).Compared with the good prognosis group,the levels of serum Galectin-3,CXCL-16,NIHSS score and low density lipoprotein cholesterol(LDL-C)in the poor prognosis group increased,and the middle carotid thickness≥1.2 mm increased(P<0.05).Serum CXCL-16,Galectin-3,NIHSS score,elevated LDL-C level and carotid middle layer thickness≥1.2 mm were risk fac⁃tors for poor prognosis in patients with ACI(P<0.05).The area under the curve(AUC)of serum CXCL-16 and Galectin3 levels in predicting the poor prognosis of patients with ACI were 0.833 and 0.798,respectively;the sensitivity was 71.13%and 70.13%and the specificity was 83.38%and 85.20%,respectively.The AUC of combining the two in pre⁃dicting the poor prognosis of patients with ACI was 0.909,and the sensitivity and specificity were 87.96%and 82.38%,respectively.Conclusion The levels of serum CXCL-16 and Galectin-3 can reflect the degree of neurological deficit in patients with ACI,and the combined detection of the two can improve the predictive value of prognosis,and provide a theoretical basis for clinical monitoring of disease progress and early intervention to improve prognosis.