H-FABP、NLR、VEGF水平与急性脑梗死神经功能缺损评估及预后相关性

Correlation between the levels of H⁃FABP,NLR,VEGF and the evaluation of neurological impairment and prognosis in patients with acute cerebral infarction

目的探讨心脏型脂肪酸结合蛋白(H-FABP)、中性粒细胞与淋巴细胞比值(NLR)、血管内皮生长因子(VEGF)水平与急性脑梗死(ACI)神经功能缺损评估及预后的相关性。方法选取2021年1月至2021年12月于青岛市城阳区人民医院急诊内科就诊的96例ACI患者作为观察对象,并按照神经功能缺损评分将观察组患者分为轻度组(<4分,n=33),中度组(4~15分,n=40),重度组(>15分,n=23);按照改良Rankin量表进行评分,将患者分为预后不良组(<3分,n=35)和预后良好组(≥3分,n=61)。比较轻度组、中度组以及重度组的H-FABP、NLR、VEGF水平,比较预后不良组和预后良好组的H-FABP、NLR、VEGF水平。采用Pearson相关性分析分析H-FABP、NLR、VEGF水平与ACI患者神经功能缺损程度的相关性。采用Logistic回归分析ACI患者预后不良的独立危险因素。采用受试者工作(ROC)曲线评估H-FABP、NLR、VEGF对ACI患者预后不良的预测价值。结果H-FABP、NLR水平比较:轻度组<中度组<重度组,预后良好组<预后不良组,VEGF水平:轻度组>中度组>重度组,预后良好组>预后不良组,差异具有统计学意义(F=45.928、42.396,t=12.657、13.520,F=66.335,t=81.667,P<0.05)。Pearson相关性分析结果显示,H-FABP、NLR水平均与ACI患者神经缺损程度呈正相关,VEGF水平均与ACI患者神经缺损程度呈负相关(r=0.556、0.674、-0.701,P<0.05)。Logistic回归分析结果显示,H-FABP、NLR、VEGF均为ACI患者预后不良的独立影响因素(P<0.05)。ROC曲线显示,H-FABP、NLR、VEGF以及联合检测预测ACI患者预后不良的曲线下面积为0.754、0.769、0.733、0.901。结论H-FABP、NLR、VEGF水平与ACI患者神经功能缺损以及预后具有一定的相关性,且H-FABP、NLR、VEGF联合检测对ACI患者预后不良具有较高的价值,能够为临床评估患者预后结果提供参考价值。

Objective To investigate the relationship between the levels of heart type fatty acid binding protein(H⁃FABP),neutrophil lymphocyte ratio(NLR),vascular endothelial growth factor(VEGF)and the evaluation of neurological impairment and prognosis in acute cerebral infarction(ACI).Methods From January 2021 to December 2021,96 patients with ACI who were hospitalized in the Emergency Depart⁃ment of Qingdao Chengyang District People's Hospital were selected as the subjects of observation.The pa⁃tients were divided into the mild group(<4 points,n=33),the moderate group(4⁃15 points,n=40),and the severe group(>15 points,n=23)according to the neurological deficit score.Based on the modified Rankin scale,patients were divided into the poor prognosis group(<3 points,n=35)and the good prognosis group(≥3 points,n=61).The levels of H⁃FABP,NLR and VEGF in the mild group,the moderate group and the severe group were compared,and the levels of H⁃FABP,NLR and VEGF in the poor prognosis group and the good prognosis group were compared.Pearson correlation analysis was used to analyze the correlation between the levels of H⁃FABP,NLR,VEGF and the degree of neurological impairment in patients with ACI.Logistic regression was used to analyze the independent risk factors of poor prognosis in ACI patients.The predictive value of H⁃FABP,NLR,VEGF on the poor prognosis of ACI patients was evaluated by receiver operating curve(ROC).Results The levels of H⁃FABP and NLR:mild group<moderate group<severe group,good prognosis group<poor prognosis group,VEGF level:mild group>moderate group>severe group,good prog⁃nosis group>poor prognosis group,the difference was statistically significant(F=45.928,42.396,t=12.657,13.520,F=66.335,t=81.667,P<0.05).Pearson correlation analysis showed that the levels of H⁃FABP and NLR were directly associated with the degree of nerve defect in ACI patients,and the levels of VEGF were inversely associated with the degree of nerve defect in ACI patients(r=0.556,0.674,-0.701,P<0.05).Logistic regression analysis showed that H⁃FABP,NLR and VEGF were independent factors influencing the poor prognosis of ACI patients(P<0.05).The ROC curve showed that the areas under the curve of H⁃FABP,NLR,VEGF and combined detection to predict the poor prognosis of patients with ACI were 0.754,0.769,0.733 and 0.901,respectively.Conclusion The levels of H⁃FABP,NLR and VEGF have a certain correla⁃tion with the neurological deficit and prognosis of ACI patients,and the combined detection of H⁃FABP,NLR and VEGF has a high value for the poor prognosis of ACI patients,and can provide a reference value for clinical evaluation for the prognosis of patients.