血清NOX4和Galectin-3水平对急性前循环大血管闭塞性脑梗死后出血性转化预测价值

Predictive value of serum NOX4 and Galectin-3 levels in hemorrhagic transformation after acute procirculation large vascular occlusive cerebral infarction

目的 分析血清烟酰胺腺嘌呤二核苷酸磷酸氧化酶4(NOX4)、半乳糖凝集素-3(Galectin-3)水平对急性前循环大血管闭塞性脑梗死后出血性转化的预测价值。方法 选取2021-03-01-2023-03-31郑州市第七人民医院收治的168例急性前循环大血管闭塞性脑梗死患者作为研究对象,根据是否发生出血性转化分为观察组(发生出血性转化56例)及对照组(未发生出血性转化112例)。采用酶联免疫吸附(ELISA)法对患者血清NOX4、Galectin-3水平进行测定并分析两者间相关性。受试者工作特征(ROC)曲线分析血清NOX4、Galectin-3水平对急性前循环大血管闭塞性脑梗死后出血性转化的预测价值。多因素logistic回归分析急性前循环大血管闭塞性脑梗死后出血性转化的影响因素。结果 2组血管闭塞部位、入院美国国立卫生研究院卒中量表(NIHSS)评分、低密度脂蛋白(LDL-C)比较,差异有统计学意义,均P<0.05。观察组血清NOX4、Galectin-3水平分别为(143.73±30.15) ng/L、(8.04±1.42)μg/L,高于对照组的(96.32±24.13) ng/L、(5.05±0.74)μg/L,t值分别为11.024和17.964,均P<0.001。观察组患者血清NOX4、Galectin-3水平呈正相关,r=0.663,P<0.001。血清NOX4预测急性前循环大血管闭塞性脑梗死后出血性转化的曲线下面积(AUC)为0.846、截断值为114.82 ng/L,Galectin-3预测AUC为0.925、截断值为6.55μg/L,Galectin-3预测AUC高于NOX4,Z=3.034,P=0.002;两者联合预测AUC为0.941,优于NOX4单独预测,Z=3.617,P<0.001,且特异性高于各项单独预测。多因素logistic回归分析结果显示,入院NIHSS评分、LDL-C、NOX4、Galectin-3水平均是急性前循环大血管闭塞性脑梗死后出血性转化的影响因素,均P<0.05。结论 急性前循环大血管闭塞性脑梗死后出血性转化患者血清NOX4、Galectin-3水平升高,联合检测可明显提高对出血性转化的预测价值。

Objective To analyze the predictive value of serum levels of nicotinamide adenine dinucleotide phosphate oxidase:4(NOX4)and Galectin-3 for hemorrhagic transformation after acute anterior circulation great vascular occlusive cerebral infarction.Methods s A total of 168 patients with acute anterior circulation great vascular occlusive cerebral infarction diagnosed and treated in Zhengzhou Seventh People's Hospital from March 1,2023 to March 31,2023 were selected as the study objects,and were divided into observation group(56 patients with hemorrhagic transformation)and control group(112 patients without hemorrhagic transformation)according to whether hemorrhagic transformation occurred.Enzyme linked immunosorbent assay(ELISA)was used to measure the serum levels of NOX4 and Galectin-3 in patients and analyze the correlation between the two.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum NOX4 and Galectin-3 levels in predicting hemorrhagic transformation after acute anterior circulation great vascular occlusive cerebral infarction.Multivariate Logistic regression analysis was used to analyze the influencing factors of hemorrhagic transformation after acute anterior circulation great vascular occlusive cerebral infarction.Results There were significant differences in vascular occlusion site,national institute of health stroke scale(NIHSS)score and low density lipoprotein cholesterol(LDL-C)between the control group and observation group(P<0.05).The serum levels of NOX4 and Galectin-3 in the observation group were(143.73±30.15)ng/L and(8.04±1.42)μg/L,respectively,higher than those in the control group(96.32±24.13)ng/L and(5.05±0.74)μg/L,the t values were 11.024 and 17.964,respectively,with all P<0.001.The serum levels of NOX4 and Galectin-3 in the observation group were positively correlated(r=0.663,P<0.001).The area under the curve(AUC)predicted by serum NOX4 for hemorrhagic transformation after acute anterior circulation great vascular occlusive cerebral infarction was 0.846,with a cutoff value of 114.82 ng/L;Galectin-3 predicted AUC of 0.925,with a cutoff value of 6.55μg/L;the AUC predicted by Galectin-3 was higher than NOX4(Z=3.034,P=0.002).The AUC predicted by the combination of the two was 0.941,which was better than NOX4 alone prediction(Z=3.617,P<0.001),and the specificity was higher than each individual prediction.Multivariate logistic regression analysis showed that NIHSS score,LDL-C,NOX4,and Galectin-3 levels are all influential factors in hemorrhagic transformation after acute anterior circulation great vascular occlusive cerebral infarction(P<0.05).Conclusion The serum levels of NOX4 and Galectin-3 in patients with hemorrhagic transformation after acute anterior circulation great vascular occlusive cerebral infarction increase.Combined detection can significantly improve the predictive value of hemorrhagic transformation.