急性脑梗死患者血清Cav-1、VILIP-1、UCH-L1与神经功能损伤程度、脑梗死面积和预后的关系研究

Study on the Relationship between Serum Cav-1,VILIP-1,UCH-L1 and Degree of Neurological Function Damage,Cerebral Infarction Area,Prognosis in Patients with Acute Cerebral Infarction

目的:探讨急性脑梗死(ACI)患者血清陷窝蛋白1(Cav-1)、视锥蛋白样蛋白1(VILIP-1)、泛素羧基末端水解酶1(UCH-L1)与神经功能损伤程度、脑梗死面积和预后的关系。方法:选择2021年6月至2022年6月徐州医科大学附属医院收治的ACI患者120例为ACI组,另选择同期在本院进行健康检查的健康对象76例为对照组;根据美国国立卫生研究院发布的卒中量表(NIHSS)评分将ACI患者神经功能损伤程度分为轻度组、中度组和重度组,根据脑梗死面积分为大面积梗死组、中面积梗死组、小面积梗死组,根据改良Rankin量表(mRS)评分分为预后良好组和预后不良组,比较对照组与ACI组以及ACI各亚组间血清Cav-1、VILIP-1、UCH-L1水平;分析血清Cav-1、VILIP-1、UCH-L1水平与梗死面积、NIHSS评分、mRS评分的相关性,采用受试者工作特征(ROC)曲线分析血清Cav-1、VILIP-1、UCH-L1预测ACI神经功能损伤程度、脑梗死面积和预后的价值。结果:血清Cav-1、VILIP-1、UCH-L1水平对照组低于ACI组(P<0.05);轻度组低于中度组,中度组低于重度组(P<0.05);小面积梗死组低于中面积梗死组,中面积梗死组低于大面积梗死组(P<0.05);预后良好组低于预后不良组(P<0.05)。ACI患者血清Cav-1、VILIP-1、UCH-L1与NIHSS评分、梗死面积及mRS评分呈正相关(P<0.05)。血清Cav-1、VILIP-1、UCH-L1联合预测ACI神经损伤程度、脑梗死面积、预后的曲线下面积(AUC)分别为0.927、0.907、0.953,均大于单指标检测。结论:ACI患者血清Cav-1、VILIP-1、UCH-L1水平异常升高,且升高程度与患者神经功能损伤程度、脑梗死面积及预后有关,早期联合检测血清Cav-1、VILIP-1、UCH-L1水平有助于ACI病情及预后评估。

Objective:To explore the relationship between serum caveolin-1(Cav-1),cone like protein 1(VILIP-1),ubiquitin carboxyl terminal hydrolase 1(UCH-L1)and the degree of neurological function damage,cerebral infarction area and prognosis in patients with acute cerebral infarction(ACI).Methods:120 ACI patients who were admitted to Affiliated Hospital of Xuzhou Medical University from June 2021 to June 2022 were selected as the ACI group,and 76 healthy subjects who underwent health examinations in our hospital during the same period were selected as the control group.ACI patients were divided into mild,moderate,and severe groups in terms of neurological impairment according to the Stroke Scale released by the National Institutes of Health in the United States(NIHSS)Scoring.They were divided into large area infarction group,medium area infarction group,and small area infarction group based on the area of cerebral infarction.They were divided into good prognosis group and poor prognosis group according to the Modified Rankin Scale(mRS)score.The serum levels of Cav-1,VILIP-1,and UCH-L1 were compared between the control group,ACI group,and ACI subgroups.The correlation between serum levels of Cav-1,VILIP-1,and UCH-L1 with infarction area,NIHSS score,and mRS score were analyzed.The value of serum Cav-1,VILIP-1,and UCH-L1 in predicting the degree of ACI neurological damage,cerebral infarction area,and prognosis using the receiver operating characteristic(ROC)curve analysis.Results:The serum levels of Cav-1,VILIP-1,and UCH-L1 in the control group were lower than those in the ACI group(P<0.05).The mild group was lower than that of the moderate group,and the moderate group was lower than that of the severe group(P<0.05).The small area infarction group was lower than that of the medium area infarction group,and the medium area infarction group was lower than that of the large area infarction group(P<0.05).The good prognosis group was lower than that of the poor prognosis group(P<0.05).The serum levels of Cav-1,VILIP-1,and UCH-L1 in ACI patients were positively correlated with NIHSS score,infarction area,and mRS score(P<0.05).The combined prediction of serum Cav-1,VILIP-1,and UCH-L1 for the degree of ACI nerve injury,cerebral infarction area,and prognosis showed AUC values of 0.927,0.907 and 0.953,respectively,all of which were greater than single indicator detection.Conclusion:The serum levels of Cav-1,VILIP-1,and UCH-L1 in ACI patients are abnormally elevated,and the degree of elevation is related to the degree of neurological damage,cerebral infarction area,and prognosis.Early combined detection of serum levels of Cav-1,VILIP-1,and UCH-L1 is helpful for evaluating the condition and prognosis of ACI.