| 于洪远,景淑贤,景 倩.血栓分子标志物与急性缺血性脑卒中病情严重程度及溶栓预后的相关性[J].,2023,(8):1506-1510 |
| 血栓分子标志物与急性缺血性脑卒中病情严重程度及溶栓预后的相关性 |
| Correlation between Molecular Markers of Thrombosis and Severity of Acute Ischemic Stroke and Thrombolytic Prognosis |
| 投稿时间：2022-09-23 修订日期：2022-10-19 |
| DOI：10.13241/j.cnki.pmb.2023.08.021 |
| 中文关键词: 血栓分子标志物 急性缺血性脑卒中 病情严重程度 溶栓预后 相关性 |
| 英文关键词: Molecular markers of thrombosis Acute ischemic stroke Severity of disease Thrombolytic prognosis Correlation |
| 基金项目:北京市科技计划基金项目（17117） |
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| 中文摘要: |
| 摘要 目的：探究血栓分子标志物[血栓调节蛋白（TM）、凝血酶-抗凝血酶Ⅲ复合物（TAT）、纤溶酶-α2纤溶酶抑制剂复合物（PIC）、组织型纤溶酶原激活剂-抑制剂1复合物（t-PAIC）]与急性缺血性脑卒中(AIS)病情严重程度及溶栓预后的相关性。方法：选取2020年 7月至2022年6月我院神经内科收治的AIS患者120例为研究组，根据患者NIHSS评分为轻症组（n=48）、中症组（n=52）及重症组（n=20）；NIHSS评分升高组（n=50）和降低组（n=70）。同期选择我院查体中心查体的健康人群为对照组(n=30)。对比观察组和对照组、不同严重程度和不同预后患者外周血血栓分子标志物水平差异。采用Pearson相关分析法分析AIS患者外周血血栓分子标志物水平与病情严重程度及预后的相关性。利用ROC曲线评估外周血血栓分子标志物水平对AIS患者预后的预测价值。结果：AIS组患者外周血TM、TAT、PIC及t-PAIC水平明显高于对照组，差异有统计意义（P＜0.01）。重症组患者外周血TM、TAT、PIC及t-PAIC水平明显高于中症组及轻症组，中症组患者血清TM、TAT、PIC及t-PAIC水平明显高于轻症组，差异有统计意义（P＜0.01）。NIHSS评分升高组患者外周血TM、TAT、PIC及t-PAIC水平明显高于NIHSS评分降低组，差异有统计意义（P＜0.01）。外周血TM、TAT、PIC及t-PAICt水平与NIHSS评分呈正相关（r分别为0.326、0.513、0.124和0.417，P均＜0.05）。外周血TM、TAT、PIC及t-PAIC水平预估AIS患者预后的AUC 分别为 0. 737，0.850，0.762和0.712。其中TAT预估AIS患者预后的AUC、敏感度和特异性均最高。结论：AIS患者外周血TM、TAT、PIC及t-PAIC水平明显高于健康人群，可随病情严重程度及预后情况的变化而变化，其在病情评估及溶栓预后预测中具有指导价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the molecular markers of thrombus [thrombomodulin (TM), thrombin antithrombin III complex (TAT), plasmin- α 2 Plasmin inhibitor complex (PIC), tissue plasminogen activator inhibitor 1 complex (t-PAIC)] and the severity of acute ischemic stroke (AIS) and thrombolytic prognosis. Methods: 120 patients with AIS admitted to the Department of Neurology in our hospital from July 2020 to June 2022 were selected as the study group. According to the NIHSS score, the patients were divided into mild (n=48), moderate (n=52) and severe (n=20) groups; NIHSS score increased group (n=50) and decreased group (n=70). At the same time, healthy people in the physical examination center of our hospital were selected as the control group (n=30). The levels of molecular markers of peripheral blood thrombosis in patients with different severity and prognosis were compared between the observation group and the control group. Pearson correlation analysis was used to analyze the correlation between the level of molecular markers of thrombosis in peripheral blood and the severity and prognosis of AIS patients. ROC curve was used to evaluate the prognostic value of peripheral blood thrombus molecular markers in patients with AIS. Results: The levels of TM, TAT, PIC and t-PAIC in AIS group were significantly higher than those in control group(P<0.01). The levels of TM, TAT, PIC and t-PAIC in peripheral blood of patients with severe disease were significantly higher than those of patients with moderate disease and mild disease, and the levels of TM, TAT, PIC and t-PAIC in serum of patients with moderate disease were significantly higher than those of patients with mild disease, with statistical significance(P<0.01). The levels of TM, TAT, PIC and t-PAIC in peripheral blood of patients with higher NIHSS score were significantly higher than those of patients with lower NIHSS score(P<0.01). The levels of TM, TAT, PIC and t-PAICt in peripheral blood were positively correlated with NIHSS scores (r=0.326, 0.513, 0.124 and 0.417, respectively, P<0.05). The AUC of peripheral blood TM, TAT, PIC and t-PAIC levels predicting the prognosis of AIS patients were 0.737, 0.850, 0.762 and 0.712, respectively. TAT has the highest AUC, sensitivity and specificity in predicting the prognosis of AIS patients. Conclusion: The levels of TM, TAT, PIC and t-PAIC in peripheral blood of AIS patients are significantly higher than those of healthy people, which can change with the severity of the disease and the prognosis, and have guiding value in the evaluation of the disease and the prediction of the thrombolytic prognosis. |
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