血清载脂蛋白A1、S100β水平预测急性脑梗死患者预后的临床效能

Clinical efficacy of serum apolipoprotein A1 and S100βlevels in predicting the prognosis of invalids with acute cerebral infarction

目的 探究血清载脂蛋白A1(ApoA1)、中枢神经特异性蛋白(S100β)水平预测急性脑梗死(ACI)患者预后的临床效能。方法 选取2022年7月—2023年4月我院收治的142例ACI患者作为研究组,另外选取同一个时间段来自本院体检的健康人群75例为此次试验的健康对照组。根据随访记录对ACI患者的预后情况将研究组患者分为预后良好组(n=83)与预后不良组(n=59)2个亚组。利用酶联免疫吸附试验对血清ApoA1、S100β水平予以检测。采用受试者工作特征(ROC)曲线血清预测ApoA1、S100β对ACI患者预后的临床效能;多因素Logistic回归分析探究ACI患者预后相关的影响因素。结果 研究组的血清ApoA1水平低于健康组,S100β水平高于健康组(P<0.05)。预后不良组血清ApoA1水平低于预后良好组,血清S100β水平高于预后良好组(P<0.05)。血清ApoA1、S100β预测ACI患者预后不良的AUC分别为0.724(95%CI:0.674~0.769)、0.838(95%CI:0.789~0.889),截断值分别为1.15 g/L、0.62μg/L,灵敏度分别为90.53%、90.53%,特异度分别为55.53%、65.48%,二者联合诊断的AUC为0.906(0.862~0.0.956),灵敏度是88.06%,特异度是86.29%。预后不良组患者的NIHSS评分、同型半胱氨酸水平高于预后良好组(P<0.05)。多因素分析显示,血清ApoA1≤1.15g/L(OR=3.474,95%CI:1.862~6.477),血清S100β≥0.62μg/L(OR=3.892,95%CI:1.888~8.022)、同型半胱氨酸≥15.0μmol/L(OR=4.166,95%CI:1.891~9.179)是影响ACI患者预后的危险因素(P<0.05)。结论 在ACI患者中血清ApoA1呈低表达,S100β水平呈高表达,二者指标与ACI患者预后明显相关,二者联合检测对ACI患者的预后有较高的临床价值。

Objective To studythe clinical efficacy of serum apolipoprotein A1(ApoA1)and central nervous system specific protein(S100β)levels in predicting the prognosis of invalids with ACI.Methods A total of 142 invalids with ACIadmitted to our hospital from July 2022 to April 2023 were selected as the study group,and 75 healthy people who came to our hospital for physical examination were selected as the healthy control group during the same period.According to the prognosis of ACI invalids in follow-up records,the study group was divided into two subgroups:good prognosis group(n=83)and poor prognosis group(n=59).The serum levels of ApoA1 and S100βwere detected by ELISA.Receiver operating characteristic(ROC)was used to evaluate the clinical efficacy of serum ApoA1 and S100βin the prognosis of ACI invalids.The influencing factors of the prognosis of ACI invalids were explored by multivariate Logistic regression analysis.Results The serum ApoA1 level of the study group was lower than that of the control group,and S100βlevel was higher than that of the control group(P<0.05).The serum ApoA1 level in the poor prognosis group was lower than that of the control good prognosis group,and the serum S100βlevel was higher than that of the good prognosis group(P<0.05).The AUC of serum ApoA1 and S100βfor predicting poor prognosis in ACI invalids was 0.724(95%CI:0.674-0.769)and 0.838(95%CI:0.774-0.769),respectively.the cutoff values were 1.15 g/L and 0.62μg/L,the sensitivity were 90.53%and 90.53%,and the specificity was 55.53%and 65.48%,respectively.The AUC of combined diagnosis was 0.906(0.862-0.0.956),and the sensitivity was 88.06%.The specificity was 86.29%.The NIHSS score and homocysteine level in the poor prognosis group were higher thangood prognosis group(P<0.05).Serum ApoA1≤1.15 g/L(OR=3.474,95%CI:1.862-6.477),serum S100β≥0.62μg/L(OR=3.892,95%CI:1.888-8.022),homocysteine≥15.0μmol/L(OR=4.166,95%CI:1.891-9.179)were the risk factors for prognosis in ACI invalids(P<0.05).Conclusion Mental health problems such as depression,anxiety,fear and somatic symptoms exist in cancer invalids.Most invalids adopt positive coping styles.Self-efficacy and quality of life of invalids are closely related to mental health.