ficolin-3表达水平对急性脑梗死患者溶栓治疗结局的影响

Effect of Ficolin-3 Expression Level on the Outcome of Thrombolytic Therapy in Patients with Acute Cerebral Infarction

目的:研究纤维蛋白胶凝素3(ficolin-3)表达水平对急性脑梗死患者溶栓治疗结局的影响。方法:选取2019年1月—2021年6月商丘市中医院收治的80例超早期急性脑梗死患者作为研究对象,根据患者改良Rankin量表(mRS)评分将其分为预后良好组(52例)和预后不良组(28例)。入组前所有患者均给予爱通立(rt-PA)进行静脉溶栓治疗。分别于治疗前及治疗后测定两组患者血清中ficolin-3水平;治疗前及治疗后14 d、90 d时对患者进行美国国立卫生研究所卒中量表(NHISS)评分。结果:治疗后,两组患者血清中ficolin-3水平均明显增加,且预后良好组明显高于预后不良组,差异有统计学意义(t=3.629,P<0.05);治疗后14 d和90 d,预后良好组患者NHISS评分均明显降低,且治疗后90 d明显低于治疗后14 d时的NHISS评分,差异有统计学意义(t=32.257,P<0.05);治疗后14 d和90 d,预后良好组患者NHISS评分明显低于预后不良组,差异有统计学意义(t=18.451、32.257,P<0.05);治疗后90 d NHISS评分是急性脑梗死患者溶栓治疗预后的独立危险因素,治疗后血清ficolin-3水平是急性脑梗死患者溶栓治疗预后的独立保护因素。患者血清中ficolin-3水平与治疗后患者NHISS评分成正相关(r=0.536,P<0.001),与治疗后NHISS评分的降低程度成负相关(r=-0.541,P<0.001)。ROC曲线的AUC为0.746(95%CI=0.674~0.873,P<0.001),敏感性为65.49%,特异性为56.38%。当血清中ficolin-3水平低于20.28μg/L时,预后不良率较高。预后良好组治疗至14 d时未发生不良事件,预后不良组出现1例进展性卒中,1例脑出血。结论:血清ficolin-3表达水平与急性脑梗死患者溶栓治疗结局呈负相关,低血清ficolin-3水平的患者预后不良的发生率更高。

Objective:To study the effect of the expression level of ficolin-3 on the outcome of thrombolytic therapy in patients with acute cerebral infarction.Methods:Selecting 80 ultra-early acute cerebral infarction patients admitted to the hospital from January 2019 to June 2021 according to the patient’s mRS score.The patients were divided into a good prognosis group(52 cases)and a poor prognosis group(28 cases).Before enrollment,all patients were given rt-PA(Aitongli)for intravenous thrombolysis.The ficolin-3 levels in the serum of the two groups were measured before and after treatment,respectively,and the patients were scored by NHISS before treatment and 14 days and 90 days after treatment.Results:After treatment,the ficolin-3 levels in the serum of the two groups increased significantly,and the good prognosis group was significantly higher than the poor prognosis group(t=3.629,P<0.05).14 days and 90 days after treatment,the NHISS score of patients in the good prognosis group was significantly reduced,and the NHISS score 90 days after treatment was significantly lower than 14 days after treatment(t=32.257,P<0.05).14 days and 90 days after treatment,the NHISS score of the good prognosis group was significantly lower than that of the poor prognosis group(t=18.451,32.257;P<0.05).The NHISS score 90 days after treatment was an independent risk factor for the prognosis of acute cerebral infarction patients with thrombolytic therapy,and the serum ficolin-3 level after treatment was an independent protective factor for the prognosis of acute cerebral infarction patients with thrombolytic therapy.The level of ficolin-3 in the patient’s serum was positively correlated with the patient’s NHISS score after treatment(r=0.536,P<0.001),and was negatively correlated with the decrease in the NHISS score after treatment(r=-0.541,P<0.001).AUC of ROC were 0.746(95%CI=0.674~0.873,P<0.001).The sensitivity was 65.49%,and the specificity was 56.38%.When the serum ficolin-3 level was lower than 20.28μg/L.At times,the poor prognosis rate was higher.There was no adverse event occurred in the normal group after 14 days of treatment,and 1 case of progressive stroke and 1 case of cerebral hemorrhage occurred in the low value group.Conclusion:Serum ficolin-3 expression levels are negatively correlated with the outcome of thrombolytic therapy in patients with acute cerebral infarction.Patients with low serum ficolin-3 levels have higher incidence of poor prognosis.