血清Neu5Ac、S100A1水平与急性心源性脑梗死患者病情、预后的关系

Relationship between serum Neu5Ac and S100A1 levels and the condition and prognosis of cases with acute cardiogenic cerebral embolism

目的 探讨血清N-乙酰神经氨酸(Neu5Ac)、S100钙结合蛋白质A1(S100A1)水平与急性心源性脑梗死患者病情、预后的关系。方法 选取2021年9月至2023年9月承德市中心医院收治的165例急性心源性脑梗死患者,根据梗死面积将患者分为小/中面积组(梗死直径≤4 cm,97例)和大面积组(梗死直径>4 cm,68例);根据美国国立卫生研究院卒中量表(NIHSS)评分将患者分为低NIHSS组(NIHSS<16分,108例)和高NIHSS组(NIHSS≥16分,57例)。检测患者Neu5Ac、S100A1水平,根据患者出院后3个月mRS评分将其分为预后不良组(n=41)和预后良好组(n=124)。采用Pearson相关法探讨血清Neu5Ac、S100A1与脑梗死面积、NIHSS评分的关系,采用多因素logistic回归分析影响因素。结果小/中面积组Neu5Ac、S100A1水平低于大面积组,差异有统计学意义(P<0.05)。低NIHSS组Neu5Ac、S100A1水平低于高NIHSS组,差异有统计学意义(P<0.05)。血清Neu5Ac、S100A1与脑梗死面积、NIHSS评分均呈正相关(均P<0.001)。预后良好组血清Neu5Ac、S100A1低于预后不良组,差异有统计学意义(P<0.05)。预后良好组梗死面积大面积比例、入院NIHSS评分低于预后不良组,差异有统计学意义(P<0.05)。梗死面积大面积、入院NIHSS评分≥15.33分、Neu5Ac≥274.58 ng/mL、S100A1≥5.08 ng/mL是急性心源性脑梗死患者预后危险因素(P<0.05)。结论 血清Neu5Ac、S100A1与急性心源性脑梗死患者脑梗死面积、NIHSS评分有关,有望作为预测患者病情及预后的潜在标记物。

Objective To investigate the relationship between serum N-acetylneuramic acid(Neu5Ac)and S100 calcium-binding protein A1(S100A1)and the condition and prognosis of cases with acute cardiogenic cerebral embolism(ACCE).Methods A total of 165 cases with ACCE admitted to Chengde Cen-tral Hospital from September 2021 to September 2023 were selected.For this study,the cases were divided into two groups based on infarction size:a small/medium area group(97 cases with infarction diameter≤4 cm)and a large area group(68 cases with infarction diameter>4 cm).Additionally,based on NIHSS score,108 cases were categorized into a low NIHSS group(NIHSS<16)and 57 cases into a high NIHSS group(NIHSS≥16).The levels of Neu5Ac and S100A1 in the ACCE cases were measured.After 3 monthspost-discharge,the cases were further divided into a poor prognosis group(n=41)and a good prognosis group(n=124)based on their mRS scores.Pearson correlation was used to investigate the relationship between serum Neu5Ac,S100A1,in-farct size,and NIHSS score.Prognostic factors were evaluated using multivariate logistic regression.Results Serum levels of Neu5Ac and S100A1 in the small/medium area group were lower than those in the large area group(P<0.05).The serum levels of Neu5Ac and S100A1 in the low NIHSS group were lower than those in the high NIHSS group(P<0.05).Serum Neu5Ac and S100A1 were positively correlated with cerebral infarction size and NIHSS score(P<0.001).The serum Neu5Ac and S100A1 levels in cases with ACCE in the good prog-nosis group were lower compared to the poor prognosis group(P<0.05).The proportion of large infarct area and NIHSS score in the good prognosis group were also lower compared to the poor prognosis group(P<0.05).The large infarct size,NIHSS score at admission≥15.33,Neu5Ac≥274.58 ng/mL,and S100A1≥5.08 ng/mL were identified as risk factors for poor prognosis in cases with ACCE(P<0.05).Conclusion Serum Neu5Ac and S100A1 are associated with the size of cerebral infarction and NIHSS score in patients with ACCE.They may be used as potential markers to predict the disease and prognosis of patients.