高血压合并急性脑梗死患者血清MMP-9、RBP4水平与近远期预后的关系研究

Relationship between serum MMP-9,RBP4 levels and short-term and long-term prognosis in patients with hypertension complicated with acute cerebral infarction

目的探究高血压合并急性脑梗死患者血清基质金属蛋白酶-9(MMP-9)、视黄醇结合蛋白4(RBP4)水平与近远期预后的关系。方法选取2019年2月—2020年9月兰陵县人民医院收治的108例高血压合并急性脑梗死患者。统计高血压合并急性脑梗死患者住院后2周及发病6个月后预后情况。对比近期预后不良组和预后良好组患者的临床资料。Logistic多因素回归分析影响高血压合并急性脑梗死患者近期预后的有关因素。对比远期预后不良组和远期预后良好组血清MMP-9、RBP4水平。制作受试者工作特征(ROC)曲线,以曲线下面积(AUC)评价血清MMP-9、RBP4对高血压合并急性脑梗死患者远期预后不良的预测价值。结果住院后2周、发病6个月后,高血压合并急性脑梗死患者预后不良发生率分别为44.44%、29.63%。近期预后不良组高血压分级Ⅲ级占比、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血清MMP-9及RBP4水平高于预后良好组(P<0.05),近期预后不良组尿酸(UA)水平则低于预后良好组(P<0.05)。Logistic回归分析结果显示,UA、血清MMP-9及RBP4均为高血压合并急性脑梗死患者近期预后的危险因素(OR=2.930、3.380、3.445,P<0.05)。远期预后不良组血清MMP-9、RBP4水平均高于远期预后良好组(P<0.05)。ROC分析显示,血清MMP-9、RBP4对高血压合并急性脑梗死患者远期预后进行预测的最佳截断点分别为401.25μg/L、181.71 mg/L,AUC分别为0.713、0.793。结论血清MMP-9、RBP4水平与高血压合并急性脑梗死患者近远期预后均相关,可作为对高血压合并急性脑梗死患者预后进行预测的重要参考指标。

Objective To explore the relationship between serum matrix metalloproteinase-9(MMP-9)and retinol binding protein 4(RBP4)levels in patients with hypertension complicated with acute cerebral infarction and short-and long-term prognosis.Methods A total of 108 patients with hypertension and acute cerebral infarction who were admitted to our hospital from February 2019 to September 2020 were selected.The prognosis of patients with hypertension and acute cerebral infarction 2 weeks after hospitalization and 6 months after the onset of the disease was calculated.Compare the clinical data of the recent poor prognosis group and the good prognosis group.Logistic multivariate regression analysis of related factors affecting the short-term prognosis of patients with hypertension complicated with acute cerebral infarction.The serum levels of MMP-9 and RBP4 were compared between the poor long-term prognosis group and the good long-term prognosis group.The receiver operating characteristic curve(ROC)was made,and the area under the curve(AUC)was used to evaluate the predictive value of serum MMP-9 and RBP4 on the long-term poor prognosis of patients with hypertension and acute cerebral infarction.Results Two weeks after hospitalization and 6 months after onset,the incidence of poor prognosis in patients with hypertension and acute cerebral infarction was 44.44%and 29.63%,respectively.The proportion of hypertension grade III,fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),serum MMP-9 and RBP4 levels in the recent poor prognosis group were higher than those in the good prognosis group(P<0.05),while the uric acid(UA)level was lower good prognosis group(P<0.05).Logistic regression analysis showed that UA,serum MMP-9 and RBP4 are risk factors for the short-term prognosis of patients with hypertension and acute cerebral infarction(OR=2.930,3.380,3.445;P<0.05).The levels of serum MMP-9 and RBP4 in the poor long-term prognosis group were higher than those in the good long-term prognosis group(P<0.05).ROC analysis showed that the best cut-off points for serum MMP-9 and RBP4 to predict the long-term prognosis of patients with hypertension and acute cerebral infarction were 401.25μg/L and 181.71 mg/L,respectively,and the AUC were 0.713 and 0.793,respectively.Conclusion Serum MMP-9 and RBP4 levels are related to the short-term and long-term prognosis of patients with hypertension and acute cerebral infarction,and can be used as important reference indicators for predicting the prognosis of patients with hypertension and acute cerebral infarction.