ROCK2和KLF6在急性缺血性脑卒中的表达变化及其与病情程度和预后的相关性

Expression Changes of ROCK2 and KLF6 in Acute Ischemic Stroke and Their Correlation with Disease Severity and Prognosis

目的探究Rho相关蛋白激酶2(ROCK2)和Krüppel样因子6(KLF6)在急性缺血性脑卒中(AIS)患者血清表达变化及其与病情程度和预后的相关性。方法选取2021年1月至2023年3月在我院确诊的117例AIS患者作为研究组,另选120例在我院同期体检健康者作为对照组。根据美国国立卫生院神经功能缺损(NIHSS)评分,将患者分为轻度(46例)、中度(40例)、重度(31例)组。根据改良Rankin量表将患者分为预后良好(74例)和预后不良(43例)组。酶联免疫吸附试验测定血清ROCK2和KLF6水平。Spearman分析ROCK2和KLF6水平与NIHSS评分的关系;多因素Logistic回归分析AIS患者预后不良的危险因素;受试者工作特征(ROC)曲线分析血清ROCK2和KLF6水平对AIS患者预后不良的预测价值。结果与对照组相比,研究组ROCK2和KLF6水平显著增加(P<0.05)。与轻度组相比,中度组和重度组ROCK2和KLF6水平及NIHSS评分显著增加(P<0.05),与中度组相比,重度组ROCK2和KLF6水平及NIHSS评分显著增加(P<0.05)。相关性分析结果显示,ROCK2和KLF6水平与NIHSS评分均呈正相关(r=0.605,0.632,P<0.001)。与预后良好组相比,预后不良组患者ROCK2和KLF6水平显著增加(P<0.05)。ROCK2、KLF6单独及联合预测AIS患者预后不良的曲线下面积(AUC)分别为0.886(95%CI 0.822~0.949)、0.850(95%CI 0.770~0.930)、0.954(95%CI 0.919~0.988)。预后良好组与预后不良组患者总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)水平及NIHSS评分比较差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示TG水平、NIHSS评分、ROCK2和KLF6是AIS患者预后不良的独立危险因素(P<0.05)。结论AIS患者ROCK2和KLF6表达上调,其水平与病情程度及预后不良密切相关。

Objective To investigate the changes in serum expression of coiled-coil-containing protein kinase 2(ROCK2)and Krüppel like factor 6(KLF6)in patients with acute ischemic stroke(AIS)and their correlation with disease severity and prognosis.Methods From January 2021 to March 2023,117 AIS patients diagnosed in our hospital were collected as study group,and another 120 healthy individuals who underwent physical examination in our hospital were collected as reference group.According to the National Institutes of Health Neurological Impairment(NIHSS)score,patients were separated into mild(46 cases),moderate(40 cases),and severe(31 cases)groups.According to the modified Rankin scale,patients were grouped into good prognosis group(74 cases)and poor prognosis group(43 cases).Enzyme-linked immunosorbent assay(ELISA)was applied to measure serum levels of ROCK2 and KLF6.Spearman was applied to analyze the relationship between ROCK2,KLF6 levels and NIHSS scores.Multivariate Logistic regression was applied to analyze the risk factors for poor prognosis in AIS patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum ROCK2,KLF6 levels for poor prognosis in AIS patients.Results Compared with reference group,ROCK2,KLF6 in study group were obviously increased(P<0.05).Compared with mild group,ROCK2,KLF6,and NIHSS score were obviously increased in moderate and severe groups(P<0.05).Compared with moderate group,ROCK2,KLF6,and NIHSS score were obviously increased in severe group(P<0.05).The correlation analysis results showed that ROCK2 and KLF6 were positively correlated with NIHSS score(r=0.605,0.632,P<0.001).Compared with good prognosis group,ROCK2 and KLF6 in poor prognosis group were obviously increased(P<0.05).The area under curve(AUC)of ROCK2 and KLF6 alone and in combination predicted poor prognosis in AIS patients was 0.886(95%CI 0.822~0.949),0.850(95%CI 0.770~0.930),and 0.954(95%CI 0.919~0.988),respectively.There were significant differences in total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and NIHSS score between good and poor prognosis group(P<0.05).Multivariate Logistic regression analysis showed that TG,NIHSS scores,ROCK2,and KLF6 were independent risk factors for poor prognosis in AIS patients(P<0.05).Conclusion The expression of ROCK2 and KLF6 is up-regulated in AIS patients,and their are closely related to the severity of disease and poor prognosis.