铁离子、AQP4与急性脑梗死超时间窗动脉取栓后颅内出血转化关系及意义
Relationship and significance of iron ions,AQP4 and intracranial hemorrhage transformation after time-window artery thrombectomy in acute cerebral infarction
张敏 1王建桥 2袁振兴2
作者信息
- 1. 065000 河北,廊坊市人民医院检验科
- 2. 065000 河北,廊坊市人民医院神经内科
- 折叠
摘要
目的 分析铁离子、水通道蛋白4(AQP4)与急性脑梗死(ACI)超时间窗动脉取栓后颅内出血转化关系及意义.方法 分析2021年5月至2024年2月廊坊市人民医院收治的188例接受动脉取栓治疗的超时间窗ACI患者的临床资料,根据动脉取栓后是否发生颅内出血转化分为转化组(32例)、未转化组(156例).比较两组基线资料及铁离子、AQP4水平,经Spearman法分析铁离子、AQP4与超时间窗ACI患者动脉取栓后颅内出血转化呈正相关的相关性,Logistic回归分析铁离子、AQP4对超时间窗ACI患者动脉取栓后颅内出血转化的影响,受试者工作特征(ROC)曲线分析铁离子、AQP4单独及联合预测超时间窗ACI患者动脉取栓后颅内出血转化的作用.结果 转化组美国国立卫生研究院脑卒中量表(NIHSS)评分及铁离子、AQP4[(12.53±2.74)分、(35.45±5.28)µmol·L-1、(1.62±0.58)ng·L-1]高于未转化组[(8.69±1.50)分、(32.67±3.01)µmol·L-1、(1.00±0.23)ng·L-1],差异有统计学意义(P＜0.05);Spearman 分析结果显示,铁离子(r=0.625)、AQP4(r=0.618)与超时间窗ACI患者动脉取栓后颅内出血转化呈正相关(P＜0.05);Logistic 回归分析显示,NIHSS 评分(OR=1.300,95％CI:1.204～1.403)、铁离子(OR=1.166,95％CI:1.055～1.289)、AQP4(OR=1.220,95％CI:1.114～1.336)均与超时间窗 ACI 患者动脉取栓后颅内出血转化相关,校正NIHSS评分后,铁离子(OR=1.130,95％CI:1.027～1.244)、AQP4(OR=1.213,95％CI:1.085～1.357)仍是取栓后颅内出血转化的独立相关影响因素(P＜0.05);铁离子、AQP4预测超时间窗ACI患者动脉取栓后颅内出血转化的曲线下面积(AUC)分别为0.778(95％CI:0.712～0.836)、0.791(95％CI:0.726～0.847),联合预测AUC为 0.916(95％CI:0.867～0.951).结论 铁离子、AQP4 水平与超时间窗ACI患者动脉取栓后颅内出血转化独立相关,联合检测对出血转化具有一定预测价值,可作为临床预测颅内出血转化的辅助指标,并可作为潜在治疗靶点,指导后续临床工作.
Abstract
Objective To analyze the relationship and significance of iron ions,aquaporin 4(AQP4)and intracranial hemorrhage transformation after time-window arterial thrombectomy in acute cerebral infarction(ACI).Methods The clinical data of 188 patients with ACI over time window who received arterial thrombectomy from May 2021 to February 2024 in Langfang People's Hospital were analyzed.According to whether intracranial hemorrhage transformed after arterial thrombectomy,they were divided into converted group(32 cases)and non-converted group(156 cases).Baseline data and levels of iron ion and AQP4 were compared between the two groups.Spearman method was used to analyze the positive correlation between iron ion and AQP4 and intracranial hemorrhage transformation in ACI patients after arterial thrombectomy,and Logistic regression was used to analyze the effects of iron ion and AQP4 on intracranial hemorrhage transformation in ACI patients after arterial thrombectomy.Receiver operating characteristic(ROC)curve analysis of iron ion and AQP4 alone and combined to predict intracranial hemorrhage transformation after arterial thrombolysis in patients with ACI beyond the time window.Result The National Institutes of Health Stroke Scale(NIHSS)score,iron ion,AQP4[(12.53±2.74)scores,(35.45±5.28)μ mol·L-1,(1.62±0.58)ng·L-1]in the converted group were higher than those in the non-converted group[(8.69±1.50)scores,(32.67±3.01)μ mol·L-1,(1.00±0.23)ng·L-1],the differences were statistically significant(P＜0.05);Spearman analysis showed that iron(r=0.625)and AQP4(r=0.618)were positively correlated with intracranial hemorrhage transformation in ACI patients after thrombectomy(P＜0.05).Logistic regression analysis showed that NIHSS score(OR=1.300,95％CI:1.204-1.403),iron ion(OR=1.166,95％CI:1.055-1.289),AQP4(OR=1.220,95％CI:1.114-1.336)were correlated with intracranial hemorrhage transformation in ACI patients after arterial embolectomy.After correcting NIHSS score,iron(OR=1.130,95％CI:1.027-1.244)and AQP4(OR=1.213,95％CI:1.085-1.357)was still an independent correlation factor for intracranial hemorrhage transformation after thrombectomy(P＜0.05).The area under the curve(AUC)of iron ion and AQP4 to predict intracranial hemorrhage transformation in ACI patients after arterial thrombectomy was 0.778(95％CI:0.712-0.836)and 0.791(95％CI:0.726-0.847),respectively,and the combined prediction AUC was 0.916(95％CI:0.867-0.951).Conclusion Iron ion and AQP4 levels are independently correlated with intracranial hemorrhage transformation after arterial thrombectomy in patients with ACI over time window.Combined detection has certain predictive value for hemorrhage transformation,and can be used as an auxiliary index for clinical prediction of intracranial hemorrhage transformation,and as a potential therapeutic target to guide follow-up clinical work.
关键词
铁离子/水通道蛋白4/急性脑梗死/超时间窗/动脉取栓/颅内出血转化Key words
Iron ions/Aquaporin-4/Acute cerebral infarction/Super time window/Arterial thrombectomy/Intracranial hemorrhage transformation引用本文复制引用
出版年
2025
NETL
NSTL
万方数据