血清TGF-β1及IL-18水平对急性脑梗死患者急诊静脉溶栓治疗预后的预测价值

Predictive value of serum TGF-β1 and IL-18 levels for prognosis of emergency intravenous thrombolytic therapy for acute cerebral infarction

目的分析血清转化生长因子β1(TGF-β1)、白细胞介素-18(IL-18)水平对急性脑梗死(ACI)患者急诊静脉溶栓治疗预后的预测价值。方法前瞻性抽取2019年1月至2020年10月郑州市第九人民医院收治的110例ACI患者作为研究对象,检测其急诊静脉溶栓治疗前血清TGF-β1、IL-18水平。治疗后随访3个月,采用改良Rankin量表(mRS)评估ACI患者预后情况,并将其分为预后良好组和预后不良组;分析血清TGF-β1、IL-18水平对ACI患者急诊静脉溶栓治疗预后的预测价值。结果110例ACI患者中预后不良38例(34.55%),预后良好72例(65.45%)。治疗前,预后不良组美国国立卫生研究院卒中量表(NIHSS)评分、血清IL-18水平均高于预后良好组,血清TGF-β1水平低于预后良好组(P<0.05);组间其他资料比较差异未见统计学意义(P>0.05)。经Logistic回归分析结果显示,治疗前NIHSS评分高、血清IL-18水平高及TGF-β1水平低与ACI患者急诊静脉溶栓治疗预后不良有关(P均<0.05)。绘制受试者工作特征曲线结果显示,治疗前血清TGF-β1、IL-18水平单独及联合预测ACI患者急诊静脉溶栓治疗预后不良风险的曲线下面积均>0.80,预测价值均理想,且以联合预测价值最佳。结论治疗前血清TGF-β1、IL-18水平对ACI患者急诊静脉溶栓治疗预后不良有一定预测价值。

Objective To analyze the predictive value of serum transforming growth factor-β1(TGF-β1)and interleukin-18(IL-18)levels for prognosis of emergency intravenous thrombolytic therapy for acute cerebral infarction(ACI).Methods One hundred and ten patients with ACI admitted to Zhengzhou Ninth People’s Hospital from January 2019 to October 2020 were prospectively selected as the study subjects.Serum TGF-β1 and IL-18 levels were detected before emergency intravenous thrombolytic therapy.The patients were followed up for 3 months after treatment,and the prognoses of ACI patients were assessed by the modified Rankin scale(MRS),and they were divided into good prognosis group and poor prognosis group.The predictive value of serum TGF-β1 and IL-18 levels on the prognosis of patients with ACI after emergency intravenous thrombolytic therapy were analyzed.Results Among the 110 patients with ACI,38 cases(34.55%)had poor prognosis,and 72 cases(65.45%)had good prognosis.Before treatment,the National Institutes of Health Stroke Scale(NIHSS)score and serum IL-18 level in the poor prognosis group were higher than those in the good prognosis group,and the serum TGF-β1 level was lower than that in the good prognosis group(P<0.05);and there was no significant difference in other data between the two groups(P>0.05).The results of Logistic regression analysis showed that the high NIHSS score,high serum IL-18 level and low TGF-β1 level before treatment were related to the poor prognosis of acute venous thrombolytic therapy in ACI patients(all P<0.05).Receiver operating characteristic curve showed that the area under the curve of preoperative serum TGF-β1 and IL-18 levels and combination of them in prediction on the risk of poor prognosis after emergency intravenous thrombolytic therapy in ACI patients were all>0.80,the predicted value was ideal,and the predictive value of the combination was the best.Conclusions The levels of serum TGF-β1 and IL-18 before treatment have certain predictive value for the poor prognosis of patients with ACI after emergency intravenous thrombolytic therapy.