缺血性脑卒中患者血清SIRT1水平与早期神经功能恶化的相关性研究

Correlation between serum SIRT1 and early neurological deterioration of patients with ischemic stroke

目的探讨缺血性脑卒中患者血清沉默信息调节因子1(Silent information regulator 1,SIRT1)水平与早期神经功能恶化(Early neurological deterioration,END)的相关性。方法选取2020年1月-2021年6月于本院就诊的缺血性脑卒中患者136例,根据患者入院72 h内是否出现END,将其分为合并END组(41例)和非END组(95例),检测并比较2组血清SIRT1水平,采用Logistic回归法分析END发生的影响因素,采用受试者工作特征曲线(Receiver operating characteristic curve,ROC)分析SIRT1诊断END发生的临床价值。结果2组患者年龄、糖尿病占比、冠心病占比、基线美国国立卫生院卒中量表(National institute of health stroke scale,NIHSS)评分比较差异显著(P<0.05);与非END组比较,合并END组患者血清SIRT1水平较低,超敏C反应蛋白(High sensitivity C-reactive protein,hs-CRP)水平较高(P<0.05);糖尿病史、年龄、hs-CRP水平及SIRT1水平是缺血性脑卒中患者发生END的独立危险因素(P<0.05);SIRT1预测缺血性脑卒中患者发生END的曲线下面积为0.753[95%CI=0.559~0.903,P<0.05],诊断特异度为81.49%,敏感度为89.15%。结论SIRT1在缺血性脑卒中早期神经功能恶化患者血清中呈低表达,且其表达水平与缺血性脑卒中患者发生END有关。

Objective To explore the relationship between serum silent information regulator 1(SIRT1)and early neurological deterioration(END)of patients with ischemic stroke.Methods The clinical data of 136 patients with ischemic stroke who were treated in our hospital from January 2020 to June 2021 were retrospectively analyzed.According to whether patients had END within 72 hours of admission,they were divided into combined END group(41 cases)and non-END group(95 cases).The serum SIRT1 in these two groups were detected,and the logistic regression method was used to analyze the independent risk factors of END.A receiver operating characteristic(ROC)curve was applied to analyze the predictive value of SIRT1 for the diagnosis of END in patients with ischemic stroke.Results There were significant differences in age,proportion of diabetes,proportion of coronary heart disease,and baseline of National Institute of Health Stroke Scale(NIHSS)scores between the combined END group and non-END group(P<0.05).Compared with the non-END group,serum SIRT1 was lower and high sensitivity C-reactive protein(hs-CRP)was higher in patients with ischemic stroke in the combined END group(P<0.05).The history of diabetes,age,serum hs-CRP and SIRT1 were independent risk factors for END in patients with ischemic stroke(P<0.05).The area under the curve(AUC)of SIRT1 was 0.753(95%CI=0.559~0.903,P<0.05)for predicting the occurrence of END in patients with ischemic stroke.The specificity for diagnosis was 81.49%,and the sensitivity was 89.15%.Conclusion The serum SIRT1 is low in the END patients with ischemic stroke,which is related to the occurrence of END.