血清可溶性淀粉样前体蛋白α与轻型缺血性脑卒中相关性研究

Correlation between serum soluble amyloid precursor protein alpha and mild ischemic stroke

目的探讨血清可溶性淀粉样前体蛋白α(sAPPα)与轻型缺血性脑卒中的相关性。方法选择2019年9月~2020年9月陆军军医大学大坪医院神经内科住院的轻型缺血性脑卒中患者43例(病例组),另选择同期我院健康管理中心进行健康体检者40例(对照组)。比较2组临床资料及血清sAPPα水平,采用多因素logistic回归分析轻型缺血性脑卒中患者的影响因素,绘制ROC曲线判断血清sAPPα识别轻型缺血性脑卒中的价值。结果病例组高血压比例、血清sAPPα水平明显高于对照组,HDL水平明显低于对照组(P<0.05,P<0.01)。多因素logistic回归分析显示,高血压、sAPPα与轻型缺血性脑卒中相关(OR=3.296,95%CI:1.051~10.336,P=0.041;OR=1.661,95%CI:1.309~2.106,P=0.000)。ROC曲线分析显示,血清sAPPα识别轻型缺血性脑卒中的最佳临界值为6.57μg/L,敏感性为84%,特异性为77%,曲线下面积为0.841(95%CI:0.753~0.928,P=0.000)。结论血清sAPPα水平在轻型缺血性脑卒中患者中升高,血清sAPPα>6.57μg/L对轻型缺血性脑卒中的早期识别具有一定价值。

Objective To investigate the correlation between serum soluble amyloid precursor protein alpha(sAPPα)and mild ischemic stroke(MIS).Methods A cross-sectional study was performed on 43 MIS patients(case group)hospitalized in our hospital from September 2019 to September 2020,and 40 healthy individuals(control group)who taking physical examination during the same period.Their clinical data and serum sAPPαlevels were compared between the two groups.Multivariate logistic regression analysis was used to explore the influencing factors of MIS.Reciver operating characteristic(ROC)curve was drawn to investigate the value of serum sAPPαin the diagnosis of MIS.Results Compared with the controls,the case group had larger proportion of hypertension,and higher serum sAPPαlevel,but lower HDL level(P<0.05,P<0.01).The results of multivariate logistic regression analysis showed that hypertension and serum sAPPαwere associated with MIS(OR=3.296,95%CI:1.051-10.336,P=0.041;OR=1.661,95%CI:1.309-2.106,P=0.000).ROC curve analysis showed that the best cut-off value of serum sAPPαfor the diagnosis of MIS was 6.57μg/L,with a sensitivity of 84%,a specificity of 77%,and an area under the curve of 0.841(95%CI:0.753-0.928,P=0.000).Conclusion Serum sAPPαlevel is elevated in MIS patients.The level>6.57μg/L has certain value in early identification for the disease.