血清PCSK9对缺血性脑卒中患者颈动脉支架成形术预后评估预测价值

Predictive value of serum PCSK 9 in evaluating prognosis of carotid artery stenting in patients with ischemic stroke

目的 研究血清前蛋白转化酶枯草溶菌素9 (PCSK9)对缺血性脑卒中患者颈动脉支架成形术预后评估预测价值。方法 选取在商丘市中医院接受治疗的急性缺血性脑卒中患者120例,所有患者均给予颈动脉支架成形术。分别于手术前及手术后,采用酶联免疫吸附法测定患者血清中PCSK9水平。治疗后90 d,采用改良Rankin评分(mRS)对患者的预后进行评价,根据评分将患者分为预后良好组和预后不良组,比较预后良好组和预后不良组患者血清中PCSK9水平的差异。结果 治疗后,患者血清中PCSK9水平降低(P<0.05);预后良好率为88.33%,预后不良率为11.67%。治疗前及治疗后,预后不良组患者血清PCSK9水平均高于预后良好组(P<0.05)。术前患者血清PCSK9的cut-off值为90.34 ng/mL,PCSK9表达水平的曲线下面积(AUC)及95%CI分别为0.859(95%CI:0.810~0.905, P<0.001);术后患者血清PCSK9的cut-off值为84.42 ng/mL,PCSK9表达水平的AUC及95%CI分别为0.839 (95%CI:0.785~0.894, P<0.001);提示血清PCSK9对缺血性脑卒中患者颈动脉支架成形术预后评估具有一定的预测价值。结论 血清PCSK9对缺血性脑卒中患者颈动脉支架成形术预后评估具有一定的预测价值。

【Objective】To study the predictive value of serum proprotein convertase subtilisin/kexin type 9(PCSK9)in the prognostic evaluation of carotid artery stenting in patients with ischemic stroke.【Methods】A total of 120 patients with acute ischemic stroke who were treated in Shangqiu Hospital of Traditional Chinese Medicine were selected.All patients were given carotid artery stenting.Before and after the operation,enzyme-linked immunosorbent assay was used to determine the level of PCSK9 in the patient's serum.Ninety days after treatment,Modified Rankin Scale(mRS)score was used to evaluate the prognosis of the patients,and the patients were divided into a good prognosis group and a poor prognosis group according to the score.The differences in serum PCSK9 levels between the good prognosis group and the poor prognosis group were compared.【Results】After treatment,the level of PCSK9 in the patient's serum was significantly reduced(P<0.05).The good prognosis rate was 88.33%,and the poor prognosis rate was 11.67%.Before and after treatment,the serum PCSK9 level of patients in the poor prognosis group was significantly higher than the good prognosis group(P<0.05).The cut-off value of serum PCSK9 in patients before operation was 90.34 ng/mL,and the AUC and 95%CI of PCSK9 expression level were 0.859(95%CI:0.810–0.905,P<0.001);the cut-off value of serum PCSK9 in patients after operation was 84.42 ng/mL,and the AUC and 95%CI of PCSK9 expression level were 0.839(95%CI:0.785–0.894,P<0.001),respectively,suggesting that serum PCSK9 has a certain predictive value for the prognosis evaluation of carotid artery stenting in patients with ischemic stroke.【Conclusion】Serum PCSK9 has a certain predictive value in evaluating the prognosis of carotid artery stenting in patients with ischemic stroke.