血清SAA、TM和TAFI水平与急性缺血性脑卒中病情进展和预后的相关性

Correlation of serum SAA,TM and TAFI levels with the disease progression and prognosis in patients with acute stroke

目的研究血清淀粉样蛋白A(SAA)、血栓调节蛋白(TM)和凝血酶激活的纤溶抑制物(TAFI)水平与急性脑卒中病情进展和预后的相关性。方法选择2020年1月至2022年10月郑州大学第一附属医院收治的94例急性缺血性脑卒中患者为观察组,选择同期92例健康体检人员为对照组。观察组患者入院后根据美国国立卫生研究院卒中量表(NIHSS)评分分为轻度组(n=32,NIHSS评分0~4分)、中度组(n=38,NIHSS评分4~15分)与重度组(n=24,NIHSS评分在15分以上),出院后随访6个月,根据格拉斯哥预后评分(GOS)分为预后不良组(n=40,GOS评分1~3分)与预后较好组(n=54,GOS评分4~5分)。比较轻度组、中度组、重度组与对照组血清SAA、TM及TAFI水平;比较预后不良组与预后较好组血清SAA、TM及TAFI水平;分析血清SAA、TM及TAFI水平与患者病情严重程度及预后的相关性。结果轻度组、中度组、重度组血清SAA、TM水平显著高于对照组,TAFI水平显著低于对照组;中度组与重度组血清SAA、TM水平显著高于轻度组,TAFI水平显著低于轻度组;重度组血清SAA、TM水平显著高于中度组,TAFI水平显著低于中度组,差异均有统计学意义(P均<0.05);预后不良组血清SAA、TM水平显著高于预后较好组,TAFI水平显著低于预后较好组,差异均有统计学意义(P均<0.05);相关性分析结果显示,血清SAA、TM水平与NIHSS评分呈正相关,TAFI水平与IHSS评分呈负相关;血清SAA、TM水平与GOS评分呈负相关,TAFI水平与GOS评分呈正相关。结论血清SAA、TM水平与急性缺血性脑卒中患者病情严重程度呈正相关,与预后呈负相关,TAFI水平与患者病情严重程度呈负相关,与预后呈正相关。

Objective To study the correlation of serum amyloid A(SAA),thrombomodulin(TM)and thrombin-activatable fibrinolysis inhibitor(TAFI)levels with the disease progression and prognosis in patients with acute stroke.Methods Ninety-four patients with acute ischemic stroke admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to October 2022 were selected as the observation group,and 92 healthy physical examination personnel during the same period were selected as the control group.The observation group was divided into mild group(n=32,NIHSS 0-4 points),moderate group(n=38,NIHSS 4-15 points)and severe group(n=24,NIHSS above 15 points)according to the National Institutes of Health Stroke Scale(NIHSS)score after admission.The patients were followed up for 6 months after discharge.According to glasgow prognosis score(GOS),they were divided into poor prognosis group(n=40,GOS score 1-3 points)and good prognosis group(n=54,GOS score 4-5 points).The serum levels of SAA,TM and TAFI were compared between mild group,moderate group,severe group and control group.The serum levels of SAA,TM and TAFI were compared between the poor prognosis group and the good prognosis group.The correlation of serum levels of SAA,TM and TAFI with the severity and prognosis of the patients was analyzed.Results The serum levels of SAA and TM in mild,moderate and severe groups were significantly higher than those in control group,and the serum levels of TAFI were significantly lower than those in control group(P<0.05).The levels of SAA and TM in the moderate and severe groups were significantly higher than those in the mild group,and the levels of TAFI were significantly lower than those in the mild group(P<0.05).The levels of SAA and TM in severe group were significantly higher than those in moderate group,and the levels of TAFI were significantly lower than those in moderate group,with significant differences(all P<0.05).The levels of SAA and TM in the poor prognosis group were significantly higher than those in the good prognosis group,and the levels of TAFI were significantly lower than those in the good prognosis group,with significant differences(P<0.05).The results of correlation analysis showed that SAA and TM levels were positively correlated with NIHSS score,while TAFI levels were negatively correlated with IHSS score(P<0.05).Serum SAA and TM levels were negatively correlated with GOS score,while TAFI levels were positively correlated with GOS score(P<0.05).Conclusions The levels of serum SAA and TM are positively correlated with the severity of the disease and negatively correlated with the prognosis,and the levels of serum TAFI is negatively correlated with the severity of the patients disease and positively correlated with the prognosis.