内皮细胞微粒预测急性脑卒中预后转归的临床价值

Clinical value of endothelial microparticles in predicting prognosis of acute stroke

目的 分析内皮细胞微粒(EMPs)预测急性脑卒中(AIS)预后转归的临床价值。方法 随机连续招募2019年4月—2021年9月于西安交通大学第二附属医院明确诊断为AIS患者127例,归为AIS组;招募同期于本院体检的健康志愿者130例,归为对照组。抽取所有受试者血标本检测EMPs水平,比较两组EMPs水平差异,AIS患者院外预后转归,分析影响AIS预后不良因素,评估EMPs预测AIS临床预后的价值。结果 与对照组相比,AIS组循环低密度脂蛋白(LDL-C)、同型半胱氨酸(Hcy)及EMPs水平显著升高;预后不良亚组较预后良好亚组患者Hcy、EMPs、NIHSS评分及mRs评分显著增加;多因素Logistic回归分析发现,mRs评分、EMPs、NIHSS评分及Hcy是AIS患者预后不良的独立危险因素,其优势比分别为2.39(1.29~5.85)、20.77(14.01~36.32)、6.13(3.84~15.01)及1.08(1.02~1.46);EMPs预测AIS预后不良的价值曲线下面积(AUC)(95%CI)为0.83(0.77~0.91)。结论 EMPs是影响AIS患者预后不良的独立危险因素,同时也是潜在的评估预后不良的指标。

Objective To analyze the clinical value of endothelial microparticles(EMPs)in predicting prognosis of acute ischemic stroke(AIS).Methods 127 patients with AIS in Second Affiliated Hospital of Xi'an Jiaotong University,from April 2019 to September 2021 were recruited randomly and continuously in our study as AIS group,and 130 healthy volunteers who had undergone physical examination at the same period were recruited as control group.The blood samples of all subjects were tested for EMPs and compared their differences between two groups,and the prognosis of AIS patients within 6 months after discharge was followed-up to analyze the influencing factors of poor AIS prognosis.And explore the value of EMPs to predict the clinical prognosis of AIS.Results Compared with control group,the level of LDL-C,Hcy,and EMPs in AIS group were significantly higher;The level of Hcy,EMPs,NIHSS and mRs was higher in poor prognosis patients than those without;The mRs,EMPs,NIHSS and Hcy severed as independent risk factors for poor prognosis in AIS and their odds ratios were 2.39(1.29~5.85)and 20.77(14.01~36.32),6.13(3.84~15.01)and 1.08(1.02~1.46);The AUC(95%CI)of EMPs in predicting prognosis of AIS was 0.83(0.77~0.91).Conclusion EMPs is an independent risk factor in poor prognosis of AIS patients,and can be a potential predicting indicator of poor prognosis.