急性缺血性脑卒中患者入院时血清omentin-1水平与病情严重程度及预后的关系

Relationship between serum omentin-1 level at admission with disease severity and prognosis in patients with acute ischemic stroke

目的 分析急性缺血性脑卒中患者入院时血清omentin-1水平与病情严重程度及预后的关系。方法 选择2016-2019年在该院初次确诊并住院的急性缺血性脑卒中患者共102例作为观察组,发病时间24~72 h,选择同期性别和年龄相匹配的体检健康者50例作为对照组。采用ELISA检测所有研究对象血清omentin-1水平,分析观察组患者入院时血清omentin-1水平与反映神经功能缺损严重程度的美国国立卫生研究院卒中量表(NIHSS)评分的相关性;根据观察组治疗90 d后改良Rankin量表(mRS)评分分为预后良好组(0~2分)和预后较差组(3~6分),比较两组临床资料和入院时血清omentin-1水平;观察组根据病变相关动脉分为大动脉和小动脉亚组,分别比较两组预后良好与较差患者的入院时血清omentin-1水平;采用多因素Logistic回归分析筛选影响观察组治疗90 d预后的主要因素,采用受试者工作特征(ROC)曲线分析入院时血清omentin-1水平预测治疗90 d预后的效能。结果 观察组入院时血清omentin-1水平明显低于对照组(P<0.05)。Spearman相关分析显示,观察组入院时血清omentin-1水平与NIHSS评分呈负相关(r=-0.400,P<0.001)。与预后较差组相比,预后良好组入院时血清omentin-1水平较高,NIHSS评分降低,梗死体积缩小,差异均有统计学意义(P<0.05)。大动脉和小动脉亚组预后良好患者的入院时血清omentin-1水平均明显高于预后较差患者(P<0.05)。Logistic回归分析显示,入院时血清omentin-1水平和NIHSS评分是影响急性缺血性脑卒中患者治疗90 d预后的主要因素(P<0.05)。ROC曲线分析显示,入院时血清omentin-1水平预测治疗90 d预后的曲线下面积(AUC)为0.867(P<0.05)。结论 急性缺血性脑卒中患者入院时血清omentin-1水平降低与疾病发生、严重程度以及治疗90 d预后有紧密联系,可作为临床早期诊断急性缺血性脑卒中和判断患者短期预后的重要生化指标。

Objective To analyze the relationship between the serum omentin-1 level at admission with the severity and prognosis in the patients with acute ischemic stroke.Methods A total of 102 inpatients with initially diagnosed acute ischemic stroke in this hospital from 2016-2019 were selected as the observation group,the onset time was 24-72 h,and contemporaneous 50 gender and age-matched subjects undergoing the physical examination were selected as the control group.The serum omentin-1 level of all subjects was detected by ELISA.The correlation between the serum omentin-1 level at admission and the National Institutes of Health Stroke Scale(NIHSS)score reflecting the severity of neurological deficits in the observation group was analyzed.According to the modified Rankin Scale(mRS)scores after 90 d treatment,the observation group was divided into the good prognosis group(0-2 points)and poor prognosis group(3-6 points).The clinical data and omentin-1 levels at admission were compared between the two groups.According to the lesion-related arteries,the observation group was divided into the large arteries subgroup and small arteries subgrgoup,and the omentin-1 levels at admission were compared between the patients with good prognosis and the patients with poor prognosis in the two groups.The multivariate Logistic regression was adopted to analyze the main factors affecting the prognosis after 90 d treatment in the observation group.The efficiency of the omentin-1 level at admission for predicting the prognosis after 90 d treatment was analyzed by the operator operating characteristic(ROC)curve.Results The serum omentin-1 level at admission in the observation group was significantly lower than that in the control group(P<0.05).The Spearman correlation analysis showed that the serum omentin-1 level at admission was negatively correlated with the NIHSS score(r=-0.400,P<0.001).Compared with the poor prognosis group,the good prognosis group had higher serum omentin-1 level,lower NIHSS score and smaller infarct volume,and the differences were statistically significant(P<0.05).The omentin-1 level in patients with good prognosis of the large arteries and small arteries subgroups was significantly higher than that in the patients with poor prognosis(P<0.05).The Logistic regression analysis showed that the omentin-1 level and NIHSS score at admission were the main influencing factors for the prognosis after 90 d treatment(P<0.05).The ROC curve analysis showed that the area under the curve(AUC)of omentin-1 level at admission for predicting the prognosis after 90 d treatment was 0.867(P<0.05).Conclusion The decrease of serum omentin-1 level in the patients with acute ischemic stroke is closely related to the occurrence,severity and prognosis after 90 d treatment,which could serve as an important biochemical indicator for clinically early diagnosing acute ischemic stroke and judging the hort-term prognosis.