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血清sTWEAK在缺血性脑卒中的诊断应用价值研究

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目的 研究血清可溶性肿瘤坏死因子样弱凋亡因子(sTWEAK)水平在缺血性脑卒中(IS)患者血清中的变化,评估sTWEAK在IS的诊断应用价值。方法 选取2022年9月至2023年4月在牡丹江医学院附属红旗医院就诊的137例IS患者(IS组)和98名健康体检者(对照组)为研究对象。根据美国国立卫生院卒中量表(NIHSS)评分、急性卒中Org10172治疗试验(TOAST)病因分型对IS患者进行分组。对IS患者不同分组中血清sTWEAK浓度进行比较,评估sTWEAK对IS的诊断应用价值。结果 IS组血清sTWEAK水平高于对照组,并且随着脑卒中严重程度的加重而升高,不同TOAST分型组间的血清sTWEAK水平表达差异有统计学意义(P<0。05)。Spearman相关性分析显示,血清sTWEAK与NIHSS评分、同型半胱氨酸(Hey)水平呈正相关(r=0。780、0。790,P<0。001)。logistic二元回归分析显示,sTWEAK是IS的独立危险因素(P<0。05)。受试者工作特征(ROC)曲线显示,血清sTWEAK预测IS的最佳截断值为623。895 pg/ml、曲线下面积(AUC)为0。854,联合检测sTWEAK和Hey预测IS的AUC为0。881。结论 sTWEAK与IS的病情严重程度及TOAST分型有关,并且是IS的独立危险因素。当血清sTWEAK>623。895 pg/ml时对IS的发生有一定的预测价值,联合检测sTWEAK和Hey可以提高对IS的诊断效能。
Study on the diagnostic value of serum sTWEAK in ischemic stroke
Objective To study the changes in serum soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK)levels in patients with ischemic stroke(IS),and evaluate the diagnostic value of sTWEAK in IS.Methods A total of 137 IS patients(IS group)and 98 healthy examinees(control group)who visited the Hongqi Hospital Affiliated to Mudanjiang Medical University from September 2022 to April 2023 were selected as the study subjects.According to the National Institutes of Health stroke scale(NIHSS)score and the etiological classification of the trial of Org 10172 in acute stroke treatment(TOAST),IS patients were grouped.The serum sTWEAK concentrations in different groups of IS patients were compared and the diagnostic value of sTWEAK for IS was evaluated.Results The levels of serum sTWEAK in IS group were higher than those in control group,and it increased with the severity of stroke.The expression of serum sTWEAK level was different among different TOAST classification groups.Spearman correlation analysis showed that serum sTWEAK was positively correlated with NIHSS score and homocysteine(Hey)level(r=0.780,0.790,P<0.001).The logistic regression analysis showed that sTWEAK was an independent risk factor for IS(P<0.05).The curve of receiver's operating characteristics(ROC)showed that the best cutoff value of serum sTWEAK for predicting IS was 623.895 pg/ml,and the area under the curve(AUC)was 0.854.The AUC of combined detection of sTWEAK and Hcy for predicting IS was 0.881.Conclusion Serum sTWEAK is associated with the severity and TOAST classification of IS,and is an independent risk factor for IS.When serum sTWEAK>623.895 pg/ml,it has certain predictive value for the occurrence of IS,and the combined detection of sTWEAK and Hcy can improve the diagnostic efficiency of IS.

sTWEAKIschemic strokeNational Institutes of Health stroke scale scoreTOAST classificationHomocysteine

李梦真、查江杰、韩鹏飞、程铭、周硕、陈志会

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牡丹江医学院第一临床医学院,黑龙江牡丹江 157000

牡丹江医学院附属红旗医院检验科,黑龙江牡丹江 157000

牡丹江医学院附属红旗医院急诊科,黑龙江牡丹江 157000

sTWEAK 缺血性脑卒中 美国国立卫生院卒中量表评分 TOAST分型 同型半胱氨酸

2024

中国医药科学
海峡两岸医药卫生交流协会 二十一世纪联合创新(北京)医药科学研究院

中国医药科学

影响因子:1.083
ISSN:2095-0616
年,卷(期):2024.14(21)