Essen卒中风险评分联合OX-LDL、UCH-1对非房颤人群首发急性缺血性脑卒中患者短期预后的预测价值

Predictive value of Essen stroke risk score combined with oxidized low-density lipoprotein(OX-LDL)and ubiquitin C-terminal hydrolase(UCH-L1)in short-term prognosis of patients with first acute ischemic stroke in non-atrial fibrillation population

目的探讨Essen卒中风险评分联合氧化型低密度脂蛋白胆固醇(Oxidized low-density lipoprotein,OX-LDL)、血清泛素C末端水解酶L1(Ubiquitin carboxy-terminal hydrolase-L1,UCH-L1)对非房颤人群首发急性缺血性脑卒中(Acute ischemic stroke,AIS)患者短期预后的预测价值。方法根据改良Rankin量表(Modified rankin scale,mRS)评分,将132例非房颤人群首发AIS患者分为预后良好组(mRS≤2分)93例,预后不良组(mRS>2分)39例,在入院治疗前进行Essen卒中风险评分和血清OX-LDL、UCH-L1检测。采用Spearman相关性分析Essen卒中风险评分与OX-LDL、UCH-L1水平的差异,采用Logistic回归分析预后不良的危险因素,采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析Essen卒中风险评分、OX-LDL、UCH-L1水平及三者联合对非房颤人群首发AIS预后评估的效果。结果预后不良组Essen卒中风险评分高于预后良好组(Z=-5.365,P<0.001),血清中OX-LDL、UCH-L1水平高于预后良好组(Z=-6.152,P<0.001;Z=-7.020,P<0.001)。血清中OX-LDL、UCH-L1水平与Essen评分呈正相关(r=0.629,P<0.001;r=0.598,P<0.001)。Logistic回归分析显示,Essen卒中风险评分、OX-LDL、UCH-L1是脑卒中预后的独立影响因素。Essen卒中风险评分联合OX-LDL、UCH-L1对非房颤人群首发AIS预后的ROC曲线下面积为0.896,灵敏度为88.54%,特异度为92.93%。结论Essen卒中风险评分联合OX-LDL、UCH-L1对非房颤人群首发AIS预后有良好的预测作用,Essen卒中风险评分、OX-LDL、UCH-L1水平越高,提示预后不良的风险越大。

Objective To investigate the predictive value of Essen stroke risk score combined with oxidized low-density lipoprotein(OX-LDL)and serum ubiquitin C-terminal hydrolase L1(UCH-L1)in short-term prognosis of patients with first acute ischemic stroke in non-atrial fibrillation.Methods According to the modified rankin scale(mRS)score,132 patients with first-episode AIS in non-atrial fibrillation population were divided into 93 patients with good prognosis(mRS≤2 points)and 39 patients with poor prognosis(MRS>2).Essen stroke risk score and serum OX-LDL and UCH-L1 were tested before the admission.Spearman correlation was used to analyze the differences between Essen stroke risk score and the levels of OX-LDL and UCH-L1,Logistic regression was used to analyze the risk factors of poor prognosis,and receiver operating characteristic(ROC)curve was used to analyze the effects of Essen stroke risk score,OXLDL and UCH-L1 levels and their combination on the prognosis evaluation of first-episode AIS in non-atrial fibrillation population.Results The Essen stroke risk score in the poor prognosis group was higher than that in the good prognosis group(Z=-5.365,P<0.001),and the concentrations of OX-LDL and UCH-L1 in serum were higher than those in the good prognosis group(Z=-6.152,P<0.001;Z=-7.020,P<0.001).Serum OX-LDL concentration and UCH-L1 concentration were positively correlated with Essen score(r=0.629,P<0.001;r=0.598,P<0.001).In multivariate Logistic regression analysis,Essen score,OX-LDL concentration and UCH-L1 concentration were independent factor affecting the prognosis of stroke.The ROC curve analysis showed that the Essen stroke risk score combined with OX-LDL and UCH-L1 had a curve area under the ROC curve of 0.896 for the prognosis of non-AF patients with first-episode acute ischemic stroke,with a sensitivity of 88.54%,and the specificity was 92.93%.Conclusion Essen stroke risk score combined with OX-LDL and UCH-L1 have a good predictive effect on the prognosis in patients of first acute ischemic stroke non-atrial fibrillation.The higher the Essen stroke risk score,OX-LDL and UCH-L1 levels,it shows the greater the risk of the poor prognosis.