血清二肽基肽酶3水平对急性脑梗死患者预后的预测价值

The Predictive Value of Serum Dipeptidyl Peptidase 3 Level inPatients with Acute Cerebral Infarction

目的探讨二肽基肽酶3(DPP3)水平对急性脑梗死患者预后的预测价值。方法收集本院2019年12月至2021年1月收治的108例急性脑梗死患者(急性脑梗死组)以及同一时期健康体检者(健康对照组)。ELISA检测血清中DPP3蛋白表达水平,并通过t检验分析DPP3水平在急性脑梗死组与健康对照组之间的表达差异。根据血清DPP3表达的中位数将患者分为DDP3高表达组54例,DDP3低表达组54例,通过卡方(χ^(2))比较两组患者临床病理特征的关系。根据急性脑梗死90d后改良后的Rankin量表(mRS)评分将患者分为预后良好组(mRS评分<2分,51例)、预后不良组(2≤mRS评分<6分,57例),通过卡方(χ^(2))单因素和Logistic多因素回归分析急性脑梗死患者预后的影响因素;ROC曲线分析评估DPP3对预后的预测价值。结果与健康对照组比较,急性脑梗死组血清中DPP3蛋白表达水平明显上调(P<0.05)。DDP3高表达组患者大动脉梗死、NIHSS评分≥5分、脑梗死体积≥1.5cm^(3)比例明显高于DDP3低表达组(P<0.05)。预后不良组患者大动脉梗死、NIHSS评分≥5分、脑梗死体积≥1.5cm^(3)、DPP3高表达比例明显高于预后良好组(P<0.05);NIHSS评分(OR=1.442,95%CI 1.144~1.817)和DPP3水平(OR=1.345,95%CI 1.101~1.643)是急性脑梗死患者预后的独立危险因素(P<0.05)。血清DPP3水平预测不良预后的曲线下面积为0.846,灵敏度和特异性分别为76.85%和82.00%。结论急性脑梗死患者血清中DPP3高表达,与梗死类型、NIHSS评分以及梗死体积等有关,可能作为急性脑梗死患者短期预后的预测标志物。

Objective To investigate the predictive value of dipeptidyl peptidase 3(DPP3)level in the prognosis of patients with acute cerebral infarction.Methods From December,2019 to January,2021,108 patients with acute cerebral infarction(acute cerebral infarction group)and selected healthy subjects(healthy control group)who were admitted to our hospital were collected for the study.The expression level of DPP3 protein in serum sample was detected by ELISA,and the expression difference of DPP3 level between acute cerebral infarction group and healthy control group was analyzed by t test.According to the median of serum DPP3 expression,these patients were grouped into the high DDP3 expression group(54 cases)and low DDP3 expression group(54 cases).According to the modified Rankin Scale(mRS)score after 90 days of acute cerebral infarction,these patients were grouped into a good prognosis group(mRS score<2 points,51 cases)and a poor prognosis group(2≤mRS score<6 points,57 cases).The influencing factors of prognosis of patients with acute cerebral infarction were analyzed by Chi-square(χ^(2))univariate and logistic multivariate regression;The predictive value of DPP3 for prognosis was assessed by ROC curve analysis.Results Compared with the healthy control group,the expression level of DPP3 protein in serum sample of the acute cerebral infarction group was significantly up-regulated(P<0.05).The proportions of large artery infarction,NIHSS score≥5 points,and cerebral infarction volume≥1.5 cm^(3)in the high DDP3 expression group were significantly higher than those in the low DDP3 expression group(P<0.05).The proportions of large artery infarction,NIHSS score≥5,cerebral infarction volume≥1.5 cm^(3),and high expression of DPP3 in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05);NIHSS score(OR=1.442,95%CI 1.144-1.817)and DPP3 level(OR=1.345,95%CI 1.101-1.643)were independent risk factors for the prognosis of patients with acute cerebral infarction(P<0.05).The area under the curve of serum DPP3 level predicting poor prognosis was 0.846,and the sensitivity and specificity were 76.85%and 82.00%,respectively.Conclusion DPP3 is highly expressed in serum of patients with acute cerebral infarction.It is related to the type of infarction,NIHSS score and infarct volume,and could be used as a predictive marker for short-term prognosis of patients with acute cerebral infarction.