氧化应激与缺血性脑卒中神经功能评分及神经功能恢复的相关性研究

Correlation between oxidative stress and neurological function scores,and neurological recovery in patients with ischemic stroke

目的:探究氧化应激反应与缺血性脑卒中患者神经功能评分及神经功能恢复的相关性。方法:选取我院2016年12月至2017年12月收治的60例缺血性脑卒中患者以及同期体检的60例健康人作为本次研究对象,将研究对象分为疾病组和对照组。比较两组血清超氧化物歧化酶(SOD)、总抗氧化能力(TAC)、丙二醛(MDA)水平。采用线性回归分析SOD、TAC、MDA与神经功能缺损评分(NIHSS评分)的相关性,采用ROC曲线分析SOD、TAC、MDA与神经功能恢复的相关性。结果:疾病组患者SOD、TAC显著低于对照组(P <0. 05); MDA高于对照组(P <0. 05)。SOD、TAC、MDA与NHISS评分相关性分析显示,SOD与NIHSS评分呈负相关(r=-0. 873,P=0. 000),TAC与NHISS评分之间呈负相关性(r=-0. 792,P=0. 000),MDA与NHISS评分之间呈正相关性(r=0. 868,P=0. 000)。经治疗后SOD、TAC水平升高,MDA水平降低。与神经功能改善预后相比,SOD ROC曲线下面积为0. 722,95%CI:0. 596～0. 849,P=0. 008; TAC ROC曲线下面积为0. 690,95%CI:0. 561～0. 818,P=0. 023; MDA ROC曲线下面积为0. 832,95%CI:0. 729～0. 935,P=0. 000。结论:缺血性脑卒中患者存在氧化应激反应异常,SOD、TAC、MDA与神经功能损失程度及神经功能恢复存在明显相关性,临床中可以通过SOD、TAC、MDA水平预测患者预后。

Objective:To investigate the correlation between oxidative stress and neurological function scores,and neurological recovery in patients with ischemic stroke.Methods:60 patients with ischemic stroke admitted to our hospital from December 2016 to December 2017 and 60 healthy subjects underwent physical examination in the same period were enrolled in this study.The objects were divided into the disease group and the control group.The levels of serum superoxide dismutase(SOD),total antioxidant capacity(TAC)and malondialdehyde(MDA)were compared between the two groups.The correlation between SOD,TAC,MDA and neurological impairment score(NIHSS)was analyzed by linear regression.The correlation between SOD,TAC,MDA and neurological recovery was analyzed by ROC curve.Results:The levels of SOD and TAC of the disease group were significantly lower than those of the control group(P<0.05).The level of MDA of the disease group was higher than that of the control group(P<0.05).The correlation analysis between SOD,TAC,MDA and NHISS scores showed that SOD was negatively correlated with NIHSS score(r=-0.873,P=0.000),and there was a negative correlation between TAC and NHISS score(r=-0.792,P=0.000).),and there was a positive correlation between MDA and NHISS score(r=0.868,P=0.000).After treatment,the levels of SOD and TAC increased and the level of MDA decreased.Compared with prognosis of neurological function improvement,the area under the SOD ROC curve was 0.722,95%CI:0.596-0.849,P=0.008;the area under the TAC ROC curve was 0.690,95%CI:0.561-0.818,P=0.023;the area under the MDA ROC curve was 0.832,95%CI:0.729-0.935,P=0.000.Conclusion:There is abnormal oxidative stress in patients with ischemic stroke.The presence of SOD,TAC and MDA is significantly correlated with the degree of neurological impairment and recovery of neurological function.The prognosis of patients with ischemic stroke can be predicted by SOD,TAC and MDA levels.