血清AQP9、PGC-1α、CTRP3在缺血性脑卒中患者中的表达及出血转化影响因素分析

Serum AQP9,PGC-1α、expression of CTRP3 in patients with ischemic stroke and analysis of influencing factors on bleeding transformation

目的分析血清水通道蛋白9(AQP9)、线粒体生物发生调节因子1α(PGC-1α)、胰岛素样生长因子结合蛋白3(CTRP3)在缺血性脑卒中(cerebral ischemic stroke,CIS)患者中的表达及出血转化(HT)影响因素。方法选取郑州市中心医院神经内科2019年6月—2022年9月收治的CIS患者88例,基于颅脑影像复查结果将其分为HT组43例和非HT组45例。收集并对比2组基线资料,检测并比较患者AQP9、PGC-1α、CTRP3表达水平。使用单因素、多因素logistic回归分析CIS患者发生HT影响因素,建立受试者工作特征曲线(ROC曲线)分析AQP9、PGC-1α、CTRP3预测CIS患者发生HT的价值。结果HT组血小板计数、基线NIHSS评分、发病至溶栓时间、AQP9水平均显著高于非HT组,PGC-1α、CTRP3水平低于非HT组(均P<0.05)。多因素logistic回归分析显示,基线NIHSS评分、发病至溶栓时间、血清AQP9、PGC-1α、CTRP3是CIS患者HT影响因素。血清AQP9、PGC-1α、CTRP3对CIS患者发生HT具有一定的预测价值(AUC=0.835、0.823、0.829,P<0.01),且三项联合(AUC=0.903,P<0.01)预测价值更高。结论血清AQP9、PGC-1α、CTRP3在CIS患者中的表达与其发生HT密切相关,三者与NIHSS评分、发病至溶栓时间、血小板计数是CIS患者发生HT的危险因素,且联合检测对CIS患者发生HT具有较好的预测价值。

Objective To analyze serum aquaporin 9(AQP9)and mitochondrial biogenic regulator 1α(PGC-1α)and expression of insulin like growth factor binding protein 3(CTRP3)in patients with cerebral ischemic stroke(CIS)and the influencing factors of hemorrhagic transformation(HT).Methods A total of 88 patients with CIS admitted to the Department of Neurology in our hospital from June 2019 to September 2022 were selected and divided into an HT group of 43 patients and a non HT group of 45 patients based on the results of brain imaging review.Collect and compare baseline data between the two groups,detect and compare patients AQP9 PGC-1αand CTRP3 expression level.Using univariate and multivariate logistic regression analysis to analyze the factors affecting the occurrence of HT in patients with CIS,establish a subject work characteristic curve(ROC curve)to analyze AQP9 PGC-1αand the value of CTRP3 in predicting the occurrence of HT in patients with CIS.Results Platelet count,baseline NIHSS score,time from onset to thrombolysis,and AQP9 levels in the HT group were significantly higher than those of the non HT group,PGC-1α,the level of CTRP3 was lower than that of the non HT group(all P<0.05).Multivariate logistic regression analysis showed that baseline NIHSS score,time from onset to thrombolysis,serum AQP9,PGC-1α,CTRP3 is a risk factor for HT in patients with CIS.Serum AQP9,PGC-1α,CTRP3 has a certain predictive value for the occurrence of HT in patients with CIS(AUC=0.835,0.823,0.829,P<0.01),and the combination of three factors(AUC=0.903,P<0.01)has a higher predictive value.Conclusion Serum AQP9,PGC-1α,the expression of CTRP3 in patients with CIS is closely related to the occurrence of HT.The association of the three factors with NIHSS score,time from onset to thrombolysis,and platelet count is a risk factor for the occurrence of HT in patients with CIS.The combined detection of CTRP3 has good predictive value for the occurrence of HT in patients with CIS.