血清CCL5、P2X7R水平与大血管闭塞性急性缺血性脑卒中并发恶性脑水肿的关系
Predictive value of serum CCL5 and P2X7R levels in acute ischemic stroke with large vessel occlusion complicated with malignant brain edema
王菲 1张娟利 1苏航 1赵毅1
作者信息
- 1. 西电集团医院神经内科,西安 710077
- 折叠
摘要
目的 探讨血清C-C基序趋化因子配体5(CCL5)、嘌呤能2X7受体(P2X7R)水平与大血管闭塞性急性缺血性脑卒中(AIS-LVO)并发恶性脑水肿(MBE)的关系.方法 选择AIS-LVO患者162例(观察组),接受静脉溶栓联合机械取栓治疗后72 h并发MBE 43例、未并发MBE 119例,同期另选体检健康的志愿者60例作为对照组.采集所有研究对象外周静脉血,离心留取血清,采用ELISA法检测血清CCL5、P2X7R.采用多因素Logistic回归模型分析AIS-LVO并发MBE的危险因素,采用受试者工作特征(ROC)曲线分析血清CCL5、P2X7R水平对AIS-LVO并发MBE的预测价值.结果 观察组血清CCL5、P2X7R水平均高于对照组(P均<0.05).单因素分析发现,AIS-LVO患者并发MBE者NIHSS评分、ASPECTS评分及血清CCL5、P2X7R水平均高于其未并发MBE者(P均<0.05);多因素Logistic回归分析发现,NIHSS评分增加及血清CCL5、P2X7R水平升高为AIS-LVO并发MBE的独立危险因素(P均<0.05).ROC曲线分析发现,血清CCL5、P2X7R水平单独和联合预测AIS-LVO并发MBE的曲线下面积(AUC)分别为0.780、0.790、0.880,血清CCL5、P2X7R水平联合预测AIS-LVO并发MBE的AUC大于二者单独(P均<0.05).结论 血清CCL5、P2X7R水平升高是AIS-LVO并发MBE的独立危险因素;血清CCL5、P2X7R水平对AIS-LVO并发MBE均有一定预测价值,二者联合预测价值更高.
Abstract
Objective To investigate the predictive value of serum levels of C-C motif chemokine ligand 5(CCL5)and purinergic 2X7 receptor(P2X7R)in acute ischemic stroke with large vessel occlusion(AIS LVO)complicated with malignant cerebral edema(MBE).Methods Totally 162 patients with AIS-LVO(observation group)were selected.After receiving intravenous thrombolysis combined with mechanical thrombectomy,43 cases with MBE and 119 cases without MBE were diagnosed 72 h later,and 60 healthy volunteers were selected as the control group during the same period.Periph-eral venous blood of all subjects was collected,serum was collected by centrifugation,and serum CCL5 and P2X7R were de-tected by ELISA.Multivariate Logistic regression model was used to analyze the risk factors of AIS-LVO complicated with MBE,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum CCL5 and P2X7R levels in AIS-LVO complicated with MBE.Results The serum levels of CCL5 and P2X7R in the observation group were higher than those in the control group(both P<0.05).Univariate analysis showed that NIHSS score,ASPECTS score and serum CCL5 and P2X7R levels of AIS-LVO patients with MBE were higher than those of AIS-LVO patients without MBE(all P<0.05).Multivariate Logistic regression analysis showed that the increase of NIHSS score and serum CCL5 and P2X7R levels were independent risk factors for AIS-LVO complicated with MBE(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum CCL5 and P2X7R levels independently and jointly in predicting AIS-LVO complicated with MBE were 0.780,0.790 and 0.880,respectively.The AUC of serum CCL5 and P2X7R combined in predicting AIS-LVO complicated with MBE was greater than that of either alone(both P<0.05).Conclusions Increased levels of serum CCL5 and P2X7R are independent risk factors for AIS-LVO complicated with MBE.Serum CCL5 and P2X7R levels have certain predictive value for AIS-LVO complicated MBE,and the combined detection of the two has a higher predictive value.
关键词
大血管闭塞性急性缺血性脑卒中/恶性脑水肿/C-C基序趋化因子配体5/嘌呤能2X7受体Key words
large vessel occlusive acute ischemic stroke/malignant cerebral edema/C-C motif chemokine ligand 5/purinergic 2X7 receptor引用本文复制引用
基金项目
陕西省中医药管理局委托办事经费项目(2021-ZZ-LC033)
出版年
2024
国家科技期刊平台
NSTL
万方数据