血清CXCL12与老年急性缺血性轻型脑卒中早期进展及预后的关系

The relationship between serum CXCL12 and the early progression and prognosis of acute ischemic mild stroke in the elderly

目的 探讨血清CXCL12与老年急性缺血性轻型脑卒中早期进展及预后的关系。方法 选取180例2020-04—2021-09在山东第一医科大学附属人民医院神经内科住院的老年急性缺血性轻型脑卒中患者,将患者分成进展组和非进展组,发病第5天NIHSS评分较入院首次NIHSS评分≥2分为进展组,否则为非进展组。入院当日采用自制基线资料调查表收集所有患者的基线资料,入院次日检测血清CXCL12水平。所有患者随访3个月,随访结束时对患者进行mRS量表评价,m RS评分0~2分为预后良好组,mRS评分3~4分为预后不良组。对比进展组、非进展组血清CXCL12水平的差异,比较预后良好组、预后不良组血清CXCL12水平的差异,分析各组NIHSS评分、mRS评分与血清CXCL12的相关性。结果 与非进展组比较,进展组患者血清CXCL12水平明显升高,差异有统计学意义(t=15.194,P<0.05)。与预后良好组比较,预后不良组患者血清CXCL12水平明显升高,差异有统计学意义(t=16.098,P<0.05)。NIHSS评分>4分及同型半胱氨酸>10μmol/L的患者血清CXCL12水平更高,差异有统计学意义(P<0.05)。经Pearson相关性分析,结果显示NIHSS评分与血清CXCL12的相关性系数r=0.648,P<0.05,mRS评分与血清CXCL12的相关性系数r=0.637,P<0.05。结论 CXCL12水平升高可作为老年轻型卒中进展的生物学标记物,提示预后不良。

Objective To explore the relationship between serum CXCL12 and the early progression and prognosis of acute ischemic mild stroke in the elderly.Methods One hundred and eighty elderly patients with acute ischemic mild stroke hospitalized in the Department of Neurology of the peoper’s Hospital Affiliated to shandong First Medical Uniuersity from April 2020 to September 2021 were divided into progressive group and nonprogressive group.NIHSS score≥2 on the fifth day of onset was divided into progressive group,otherwise nonprogressive group.The baseline data of all patients were collected with self-made baseline data questionnaire on the day of admission,and the serum CXCL12 level was detected on the second day after admission.All patients were followed up for 3 months.At the end of follow-up,the patients were evaluated with mRS scale.mRS score 0-2 was divided into good prognosis group,mRS score 3-4 was divided into poor prognosis group.The difference of serum CXCL12 level between progressive group and non-progressive group,and the difference of D0I:10.12083/SYSJ.230204 serum CXCL12 level between good prognosis group and poor prognosis group were compared,and the correlations between NIHSS score,mRS score and serum CXCL12 in each group were analyzed.Results Compared with the nonprogressive group,the serum CXCL12 level in the progressive group was significantly higher than that in the nonprogressive group.Compared with the group with good prognosis,the level of serum CXCL12 in the group with poor prognosis was significantly higher than that in the group with good prognosis(P<0.05).The patients with NIHSS score>4 and homocysteine>10μmol/L had higher serum CXCL12 levels,and the difference was statistically significant.By Pearson correlation analysis,the results showed that the correlation coefficient between NIHSS score and serum CXCL12 was r=0.648(P<0.05),the correlation coefficient between mRS score and serum CXCL12(r=0.637,P<0.05).Conclusion The elevated level of CXCL12 can be used as a biomarker of the progression of mild stroke in the elderly,indicating a poor prognosis.