急性脑梗死患者血清水通道蛋白4及水通道蛋白9的表达与脑损伤严重程度的相关性

Correlation between the expression of serum aquaporin 4 and aquaporin 9 and severity of brain injury in patients with acute cerebral infarction

目的探讨急性脑梗死患者血清水通道蛋白4(AQP4)、水通道蛋白9(AQP9)的表达与脑损伤严重程度的相关性。方法选取2018年6月至2020年8月开滦总医院收治的60例急性脑梗死患者为急性脑梗死组,另选取同期进行体检的健康人群58例为对照组。根据美国国立卫生研究院卒中量表(NIHSS),将急性脑梗死患者分为轻度缺损组、中度缺损组、重度缺损组。采用酶联免疫吸附法检测急性脑梗死患者血清中AQP4、AQP9水平。采用Spearman相关性分析患者血清中AQP4、AQP9与NIHSS评分的相关性;采用多因素Logistic回归分析影响急性脑梗死发生的危险因素。结果急性脑梗死组睡眠呼吸暂停综合征比例、血尿酸、抗心磷脂抗体、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、脑钠肽(BNP)、同型半胱氨酸(Hcy)均高于对照组(t/χ2=17.596、15.877、21.866、30.226、18.991、39.505、17.287、12.003,P<0.05)。与对照组相比,急性脑梗死组患者血清中AQP4、AQP9水平上升(t=29.573、20.152,P<0.05)。Spearman相关性分析结果表明,急性脑梗死患者血清中AQP4、AQP9表达与NIHSS评分呈正相关(r=0.488、0.609,P<0.05)。与轻度缺损组相比,中度缺损组患者血清AQP4、AQP9水平升高;与中度缺损组相比,重度缺损组患者血清AQP4、AQP9水平升高(F=34.454、44.728,P<0.05);多因素Logistic回归分析显示,血尿酸、抗心磷脂抗体、hs-CRP、BNP、Hcy、AQP4、AQP9是急性脑梗死的危险因素(OR=1.748、1.894、1.928、3.164、2.593、2.163、1.975,P<0.05)。结论急性脑梗死患者血清中AQP4、AQP9表达水平升高,与脑损伤严重程度密切相关。

Objective To investigate the correlation between the expression of serum aquaporin 4(AQP4),serum aquaporin 9(AQP9)and the severity of brain injury in patients with acute cerebral infarction.Methods From June 2018 to August 2020,60 patients with acute cerebral infarction admitted to Kailuan General Hospital were selected as the acute cerebral infarction group,and 58 healthy individuals who underwent physical examinations during the same period were selected as the control group.According to the National Institutes of Health Stroke Scale(NIHSS),patients with acute cerebral infarction were divided into mild,moderate and severe deficit groups.Enzyme-linked immunosorbent assay was applied to detect serum AQP4 and AQP9 levels in patients with acute cerebral infarction.Spearman correlation was applied to analyze the correlations between serum AQP4,AQP9,and NIHSS score of patients.Multivariate Logistic regression was applied to analyze the risk factors for acute cerebral infarction.Results The proportion of sleep apnea syndrome,blood uric acid,anticardiolipin antibodies,total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high sensitivity C-reactive protein(hs-CRP),brain natriuretic peptide(BNP),and homocysteine(Hcy)in the acute cerebral infarction group were higher than those in the control group(t/χ2=17.596,15.877,21.866,30.226,18.991,39.505,17.287,12.003;P<0.05).Compared with the control group,the levels of serum AQP4 and AQP9 in the acute cerebral infarction group were increased(t=29.573,20.152;P<0.05).Spearman correlation analysis showed that the expression levels of AQP4 and AQP9 in the serum of patients with acute cerebral infarction were positively correlated with NIHSS score(r=0.488,0.609;P<0.05).Compared with the mild deficit group,the levels of serum AQP4 and AQP9 in the moderate deficit group were increased;compared with the moderate deficit group,the levels of serum AQP4 and AQP9 in the severe deficit group were increased(F=34.454,44.728;P<0.05).Multivariate Logistic regression analysis showed that blood uric acid,anticardiolipin antibodies,hs-CRP,BNP,Hcy,AQP4,and AQP9 were risk factors for acute cerebral infarction(OR=1.748,1.894,1.928,3.164,2.593,2.163,1.975;P<0.05).Conclusion The expression levels of AQP4 and AQP9 in the serum of patients with acute cerebral infarction are elevated and closely related to the severity of brain injury.