血清Fractalkine、sICAM-1、IL-6水平联合检测对接受颅内大血管急性闭塞支架联合抽吸取栓患者预后的预测价值

Prognostic Value of Combined Serum Fractalkine,sICAM-1 and IL-6 Levels in Predicting the Prognosis of Patients Who Underwent Stenting Combined with Aspiration of Thrombus for Acute Occlusion of Large Intracranial Vessels

目的探讨血清不规则趋化因子、可溶性细胞间黏附因子-1(sICAM-1)、白细胞介素-6(IL-6)变化与颅内大血管急性闭塞支架联合抽吸取栓患者神经功能预后的相关性。方法选取2020年5月至2022年10月于驻马店中心医院接受支架联合抽吸取栓术治疗的136例颅内大血管急性闭塞患者为研究对象,根据术后3个月改良Rankin量表评分分为预后不良组(62例)和预后良好组(74例)。比较两组血清IL-6、sICAM-1、fractalkine水平,分析血清IL-6、sICAM-1、fractalkine水平与预后相关性,偏回归分析预后不良的影响因素,受试者工作特征(ROC)曲线分析血清fractalkine、sICAM-1、IL-6水平联合检测对大血管急性闭塞患者预后不良的预测价值,分析各指标不同水平颅内大血管急性闭塞患者预后不良的危险度。结果术后1个月预后不良组血清fractalkine、sICAM-1、IL-6水平高于预后良好组(P<0.05);术后1个月血清fractalkine、sICAM-1、IL-6水平与预后情况呈正相关(P<0.05);logistic回归分析结果显示,术后1个月血清fractalkine(>100.26μg·L^(-1))、sICAM-1(>45.20μg·L^(-1))、IL-6(>65.95 ng·L^(-1))水平为颅内大血管急性闭塞患者预后不良的危险因素(P<0.05);ROC分析结果显示,术后1个月血清fractalkine、sICAM-1、IL-6水平联合预测颅内大血管急性闭塞患者预后不良的曲线下面积为0.775,最佳预测敏感度、特异度分别为88.71%、66.22%,高于单一指标预测(P<0.05);危险度分析显示,术后1个月血清fractalkine、sICAM-1、IL-6高水平患者预后不良的危险度分别是低水平的2.373、2.148、1.820倍(P<0.05)。结论血清fractalkine、sICAM-1、IL-6参与颅内大血管急性闭塞病情进展过程,且在预测术后预后情况方面具有较高效能。

Objective To investigate the correlation between serum fractalkine,soluble inter cellular adhesion molecule-1(sICAM-1)and interleukin-6(IL-6)changes and the prognosis of neurological function in patients with acute intracranial great vessel occlusion stent combined with thrombolysis.Methods A total of 136 patients with acute intracranial great vessel occlusion who received stent combined thrombectomy in Zhumadian Central Hospital from May 2020 to October 2022 were selected as subjects.According to the modified Rankin scale score 3 months after surgery,they were divided into poor prognosis group(62 cases)and good prognosis group(74 cases).Serum levels of fractalkine,sICAM-1 and IL-6 were compared between the two groups,and the correlation between serum levels of fractalkine,sICAM-1 and IL-6 and prognosis were analyzed.Partial regression analysis was performed to analyze the influencing factors of poor prognosis in patients with acute intracranial vascular occlusion.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum fractalkine,sICAM-1 and IL-6 combined detection in patients with acute occlusion of great vessels,and to analyze the risk of poor prognosis in patients with acute occlusion of intracranial great vessels at different levels.Results The serum levels of fractalkine,sICAM-1 and IL-6 in the poor prognosis group were higher than those in the good prognosis group one month after surgery(P<0.05).Serum levels of fractalkine,sICAM-1 and IL-6 at 1 month after surgery were positively correlated with the prognosis(P<0.05).Logistic regression analysis showed that,serum fractalkine(>100.26μg·L^(-1)),sICAM-1(>45.20μg·L^(-1)),IL-6(>65.95 ng·L^(-1))1 month after surgery were risk factors for poor prognosis in patients with acute intracranial vascular occlusion(P<0.05).ROC analysis results showed that the area under the curve of serum fractalkine,sICAM-1 and IL-6 combined to predict poor prognosis in patients with acute intracranial vascular occlusion 1 month after surgery were 0.775.The best prediction sensitivity and specificity were 88.71%and 66.22%,respectively,which were higher than those predicted by single index(P<0.05).Risk analysis showed that the patients with high levels of serum fractalkine,sICAM-1 and IL-61 month after surgery had a risk of poor prognosis,which was 2.373,2.148,1.820 times higher than those with low levels,respectively(P<0.05).Conclusion Fractalkine,sICAM-1 and IL-6 are involved in the progression of acute intracranial vascular occlusion,and have high efficacy in predicting postoperative prognosis.