Dickkopf-1联合血小板-纤维蛋白凝块强度对急性缺血性脑卒中患者复发的风险评估价值

Value of Dickkopf-1 combined with ADP-induced platelet-fibrin clot strength in risk assessment of recurrence in patients with acute ischemic stroke

目的 探讨Dickkopf-1(DKK-1)联合血栓弹力图仪(TEG)参数对急性缺血性脑卒中(acute ischemic stroke,AIS)患者复发的风险的评估价值。方法 选取AIS患者293例作为研究对象,根据AIS患者的复发情况分为复发组和非复发组。收集所有研究对象的一般资料、TEG参数。采用酶联免疫吸附试剂盒检测血清DKK-1的水平。分析AIS患者复发的危险因素以及相关指标对AIS患者复发的评估价值。结果 复发组的房颤史比例明显高于非复发组(P <0.05)。复发组的凝血反应时间(RT)、凝血形成时间(KT)均低于非复发组,血小板-纤维蛋白凝块强度(MAADP)、DKK-1均高于非复发组(P <0.05)。有房颤史以及MAADP、DKK-1过高均是AIS患者复发的危险因素(P <0.05)。DKK-1联合MAADP对AIS患者复发的风险的评估价值较高,曲线下面积为0.891(95%CI:0.843~0.938)。结论 DKK-1、MAADP与AIS患者复发情况密切相关,二者联合应用对AIS患者复发的风险的评估价值较高。

Objective To explore the value of Dickkopf-1(DKK-1)combined with Thromboelastography(TEG)parameters in assessing the risk of recurrence in patients with acute ischemic stroke(AIS). Methods A total of 293 AIS patients were selected as the research objects. According to the recurrence of AIS patients,they were divided into recurrence group and non-recurrence group. The general information and TEG parameters of all subjects were collected. The level of serum DKK-1 was detected by enzyme-linked immunosorbent assay kit. The risk factors of recurrence in AIS patients was analyzed,and the evaluation value of the related indexes on the recurrence of AIS patients was explored. Results The proportion of atrial fibrillation history in the recurrence group was significantly higher than that in the non-recurrence group(P < 0.05). The reaction time(RT),and kinetic time(KT)of the recurrence group were shorter and ADP-induced platelet-fibrin clot strength(MAADP)and DKK-1were higher than those of the non-recurrence group(P < 0.05). The history of atrial fibrillation and the high level of MAADP and DKK-1 were the risk factors for the recurrence of AIS(P < 0.05). DKK-1 combined with MAADP was of high value in assessing the risk of recurrence in patients with AIS,and the area under the curve was 0.891(95%CI:0.843 ~ 0.938). Conclusion DKK-1 and MAADP are closely related to the recurrence of AIS patients,and the combined application of the two is of high value in assessing the risk of recurrence in AIS patients.