血清HMGB_(1)、BDNF水平与急性缺血性脑卒中患者预后的关系

Relationship between serum HMGB_(1),BDNF levels and prognosis in patients with acute ischemic stroke

目的探讨血清高迁移率族蛋白B_(1)(HMGB_(1))、脑源性神经营养因子(BDNF)水平与急性缺血性脑卒中(AIS)患者预后的关系。方法选取中国人民解放军联勤保障部队第987医院收治的126例AIS患者为AIS组,根据临床预后将AIS患者分为预后良好组和预后不良组,另选取65例健康体检者为对照组。检测各组血清HMGB_(1)、BDNF水平,分析血清HMGB_(1)、BDNF评估AIS患者预后的临床价值。结果AIS组血清HMGB_(1)水平高于对照组,血清BDNF水平低于对照组(P<0.05)。AIS组中随着病灶直径增加及神经损害程度加重,血清HMGB_(1)水平逐渐升高,血清BDNF水平降低(P<0.05)。与预后良好组相比,预后不良组血清HMGB_(1)水平升高,血清BDNF水平降低(P<0.05)。AIS患者血清HMGB_(1)与NIHSS评分、病灶直径及mRS评分呈显著正相关(P<0.05);而血清BDNF与NIHSS评分、病灶直径及mRS评分呈负相关(P<0.05)。血清HMGB_(1)联合BDNF预测AIS患者临床预后的曲线下面积(AUC)为0.860(95%CI为0.773~0.947),联合评估的敏感度显著高于单独检测(P<0.05)。结论血清HMGB_(1)、BDNF表达与AIS的发生、发展有关,两者可作为评估AIS患者预后的参考指标。

Objective To investigate the relationship between the levels of high mobility group box B_(1)(HMGB_(1)),brain-derived neurotrophic factor(BDNF)and prognosis in patients with acute ischemic stroke(AIS).Methods 126 AIS patients treated in the 987th hospital of the joint Logistics support force of the People's liberation army of China were selected as AIS group.According to clinical prognosis,AIS patients were divided into good prognosis group and poor prognosis group,and 65 healthy subjects were selected as control group.The levels of serum HMGB_(1) and BDNF were detected in each group.The evaluation value of serum HMG B_(1) and BDNF for prognosis of AIS patients was analyzed.Results The serum HMGB_(1) level in AIS group was significantly higher than control group,and the serum BDNF level was lower than control group(P<0.05).In AIS group,with the increase of lesion diameter and the severity of nerve damage,serum HMGB_(1) level gradually increased,and serum BDNF level decreased(P<0.05).The serum HMGB_(1) level in the poor prognosis group was higher than that in the good prognosis group,and the serum BDNF was lower than that in the good prognosis group(P<0.05).The serum HMGB_(1) level was significantly positively correlated with NIHSS score,lesion diameter and mRS score in AIS patients(P<0.05),while the serum BDNF level was negatively correlated with NIHSS score,lesion diameter and mRS score(P<0.05).The AUC of serum HMGB_(1)combined with BDNF in predicting the clinical prognosis of AIS patients was 0.860(95%CI:0.773-0.947),and the sensitivity of combined evaluation was significantly higher than that of single detection(P<0.05).Conclusion The expressions of serum HMGB_(1) and BDNF are closely related to AIS,and they can be used as reference indicators to evaluate the prognosis of AIS patients.