血清LRG1、TGF-β1水平与急性脑梗死颈动脉内膜中层厚度及近期预后不良的关系

Relationship between serum LRG1 and TGF-β1 and carotid intimal middle layerthickness and short-term poor prognosis in acute cerebral infarction

目的探讨血清富亮氨酸α-2糖蛋白-1(LRG1)、转化生长因子-β1(TGF-β1)水平与急性脑梗死(ACI)颈动脉内膜中层厚度(IMT)及近期预后不良的关系。方法选取2020年1月至2023年1月在苏州市广济医院诊治的123例ACI患者,根据IMT将患者分为正常组(23例)、增厚组(30例)和斑块组(70例),另选取同期苏州市广济医院35例体检健康者作为健康对照组,比较4组血清LRG1、TGF-β1水平及IMT。随访3个月,根据预后情况将患者分为预后良好组(75例)和预后不良组(48例),采用Pearson法分析血清LRG1、TGF-β1与IMT的相关性;采用单因素和多因素Logistic回归分析ACI患者近期预后不良的危险因素;采用受试者工作特征(ROC)曲线分析血清LRG1、TGF-β1水平对ACI患者近期预后不良的预测价值。结果健康对照组、正常组、增厚组、斑块组血清LRG1水平依次升高,TGF-β1水平则依次降低(P<0.05)。Pearson相关性分析显示,血清LRG1与IMT呈正相关,TGF-β1则与IMT呈负相关(P<0.05)。预后不良组年龄、合并糖尿病患者占比、入院美国国立卫生研究院卒中量表(NIHSS)评分、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、白细胞计数(WBC)、C-反应蛋白(CRP)及血清LRG1水平均高于预后良好组(P<0.05),发病至溶栓时间长于预后良好组(P<0.05),血清TGF-β1水平则低于预后良好组(P<0.05)。多因素Logistic回归分析显示,NIHSS评分高、发病至溶栓时间长、血清LRG1水平升高及TGF-β1水平降低均是影响ACI患者近期近期预后不良的危险因素(P<0.05)。ROC曲线结果显示,血清LRG1、TGF-β1单独及联合预测ACI患者近期预后不良的曲线下面积分别为0.824、0.708、0.902。结论ACI患者存在血清LRG1水平升高、TGF-β1水平降低的情况,血清LRG1、TGF-β1水平与IMT及ACI患者近期预后密切相关,联合检测血清LRG1、TGF-β1水平对预测ACI患者近期预后不良有较高的参考价值。

Objective To investigate the relationship between serum leucine-richα-2 glycoprotein-1(LRG1),transforming growth factor-β1(TGF-β1)and the carotid intimal middle layer thickness(IMT)and short-term poor prognosis in acute cerebral infarction(ACI).Methods A total of 123 patients with ACI who were treated in Guangji Hospital of Suzhou from January 2020 to January 2023 were selected,and the patients were divided into normal group(23 cases),thickened group(30 cases)and plaque group(70 cases)according to the IMT,and 35 healthy physical examiners in Guangji Hospital of Suzhou during the same period were selected as the health control group,and the serum LRG1,TGF-β1 levels and IMT of 4 groups were compared.The patients were followed up for 3 months and divided into good prognosis group(75 cases)and poor prognosis group(48 cases)according to the prognosis.The correlation between serum LRG1,TGF-β1 and IMT was analyzed by Pearson method.Univariate and multivariate Logistic regression were used to analyze the risk factors of short-term poor prognosis in ACI patients.The receiver operating characteristics(ROC)curve was used to analyze the predictive value of serum LRG1 and TGF-β1 for the short-term poor prognosis of ACI.Results The serum LRG1 level in health control group,normal group,thickened group and plaque group increased sequentially,and TGF-β1 level decreased sequentially(P<0.05).Pearson correlation analysis showed that serum LRG1 was positively correlated with IMT,while TGF-β1 was negatively correlated with IMT(P<0.05).Age,proportion of patients with diabetes,the National Institutes of Health Stroke Scale(NIHSS)score at admission,low-density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG),white blood cell count(WBC),C-reactive protein(CRP)and serum LRG1 levels in the poor prognosis group were higher than those in the good prognosis group(P<0.05),time from onset to thrombolysis was longer than that in the good prognosis group(P<0.0.05),while the serum TGF-β1 level was lower than that in the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that high NIHSS score,long time from onset to thrombolysis,elevated serum LRG1 level and decreased TGF-β1 level were risk factors for short-term poor prognosis in ACI patients(P<0.05).ROC curve results showed that the area under the curve of the single and combined detection of serum LRG1 and TGF-β1 for predicting the short-term prognosis of ACI patients were 0.824,0.708 and 0.902,respectively.Conclusion ACI patients have elevated serum LRG1 levels and decreased TGF-β1 levels.Serum LRG1 and TGF-β1 levels are closely related to the IMT and the short-term prognosis of ACI patients,and the combined detection of serum LRG1 and TGF-β1 levels have high reference value for predicting the short-term poor prognosis of ACI patients.