血清铜、诱导型一氧化氮合酶与急性缺血性脑卒中患者神经功能缺损及预后的相关性研究

Correlation of serum copper and inducible nitric oxide synthase with neurological deficit and prognosis in patients with acute ischemic stroke

目的 分析血清铜、诱导型一氧化氮合酶(iNOS)水平与急性缺血性脑卒中(AIS)患者神经功能损伤及其预后的关系,为临床治疗AIS提供参考依据。方法 选取2020年1月—2022年12月温岭市第一人民医院神经内科收治的118例AIS患者作为观察对象,依据美国国立卫生研究院卒中量表(NIHSS)评分,将AIS患者分为轻度组(35例)、中度组(47例)及重度组(36例);依据改良Rankin量表(mRS)评分,将AIS患者分为预后良好组(83例)及预后不良组(35例);选取同期100名健康体检者作为对照组。检测并比较各组血清铜、iNOS水平,并分析其与NIHSS、mRS评分的相关性。结果 相较于对照组,观察组血清铜[(1 436.35±128.53)μg/L vs.(1 076.64±98.41)μg/L]、iNOS[(29.78±3.04)U/mL vs.(15.43±2.26) U/mL]水平明显升高(均P<0.001);相较于AIS患者轻度组,中度组和重度组患者血清铜、iNOS水平呈升高趋势(均P<0.05);相较于预后良好组,预后不良组患者血清铜[(1 468.63±136.81)μg/L vs.(1 046.83±115.65)μg/L]、iNOS[(32.94±3.15) U/mL vs.(20.74±3.23)U/mL]水平明显增高(均P<0.001)。经Pearson相关性分析,AIS患者血清铜、iNOS水平与NIHSS评分、mRS评分呈正相关关系(均P<0.05)。结论 AIS患者血清铜、iNOS水平越高,AIS患者神经功能缺损越严重,预后越差,检测上述指标可为临床诊治AIS提供一定的参考,评估AIS患者预后。

Objective To analyze the relationship between serum copper,inducible nitric oxide synthase(iNOS)levels and neurological impairment and prognosis in patients with acute ischemic stroke(AIS),and to provide reference for clinical treatment of AIS.Methods A total of 118 patients with AIS admitted to the Department of Neurology of Wenling First People's Hospital from January 2020 to December 2022 were selected as the observation objects.According to NIHSS score,the AIS patients were divided into mild group(35 cases),moderate group(47 cases)and severe group(36 cases).According to mRS score,AIS patients were divided into good prognosis group(83 cases)and poor prognosis group(35 cases).In the same period,100 healthy subjects were selected as control subjects.The levels of serum copper and iNOS were detected and compared among all groups,and the correlation between their levels and the scores of NIHSS and mRS was analyzed.Results The serum copper[(1436.35±128.53)μg/L us.(1076.64±98.41)μg/L and iNOS[(29.78±3.04)U/mL vs.(15.43±2.26)U/mL] levels in the observation group were significantly higher than those in the control group(all P<0.001).Compared with the mild group,the serum copper and iNOS levels in the moderate group and the severe group showed a rising trend(all P<0.05).Serum copper[(1468.63±136.81)μg/L us.(1046.83±115.65)μg/L]and iNOS[(32.94±3.15)U/mL us.(20.74±3.23)U/mL]levels in patients with good prognosis were significantly higher than those in the good prognosis group(all P<0.001).Pearson correlation analysis showed that serum copper and iNOS levels in AIS patients were positively correlated with NIHSS scores and mRS scores(all P<0.05).Conclusion The higher the levels,the more severe the neurological deficit and the worse the prognosis of AIS patients.The detection of the above indicators can provide certain reference for clinical diagnosis and treatment of AIS,and can be used as prognostic indicators for AIS patients.