[1]王 婷,梁佳佳.不同TOAST分型急性脑梗死患者血清CXC趋化因子配体16、碱性髓鞘蛋白、基质金属蛋白酶-9水平变化及临床意义[J].陕西医学杂志,2021,50(12):1581-1584.[doi:DOI:10.3969/j.issn.1000-7377.2021.12.029]
　WANG Ting,LIANG Jiajia.Changes and clinical significance of serum CXCL16,MBP and MMP-9 levels in patients with different TOAST subtypes of cerebral infarction[J].,2021,50(12):1581-1584.[doi:DOI:10.3969/j.issn.1000-7377.2021.12.029]
点击复制

不同TOAST分型急性脑梗死患者血清CXC趋化因子配体16、碱性髓鞘蛋白、基质金属蛋白酶-9水平变化及临床意义
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年12期
页码:
1581-1584
栏目:
临床检验
出版日期:
2021-12-05

文章信息/Info

Title:
Changes and clinical significance of serum CXCL16,MBP and MMP-9 levels in patients with different TOAST subtypes of cerebral infarction
作者:
王 婷; 梁佳佳
(榆林市第一医院神经内科,陕西 榆林 719000)
Author(s):
WANG Ting; LIANG Jiajia
(Department of Neurology,the First Hospital of Yulin,Yulin 719000,China)
关键词:
急性脑梗死;  CXC趋化因子配体16;  碱性髓鞘蛋白;  基质金属蛋白酶-9;  类肝素药物治疗急性缺血性脑卒中试验
Keywords:
Acute cerebral infarction;  CXC chemokine ligand 16;  Myebin basic protein;  Matrix metalloproteinase-9;  TOAST
分类号:
R 743.3
DOI:
DOI:10.3969/j.issn.1000-7377.2021.12.029
文献标志码:
A
摘要:
目的:探讨根据类肝素药物治疗急性缺血性脑卒中试验(TOAST)分型后不同类型急性脑梗死(ACI)患者血清CXC趋化因子配体16(CXCL16)、碱性髓鞘蛋白(MBP)、基质金属蛋白酶-9(MMP-9)水平变化及临床意义。方法:随机选取137例ACI患者为观察组,选取同期健康体检者89例为对照组。比较两组血清CXCL16、MBP、MMP-9水平。根据TOAST对ACI患者进行分型,比较不同亚型ACI患者血清CXCL16、MBP、MMP-9水平。采用受试者工作特征(ROC)曲线分析CXCL16、MBP、MMP-9单项及联合对ACI的诊断效能。结果:观察组血清CXCL16、MBP、MMP-9水平均明显高于对照组(均P<0.05)。不同TOAST分型患者血清CXCL16、MBP、MMP-9水平比较,差异有统计学意义(均P<0.05); 大动脉粥样硬化(LAA)组CXCL16、MMP-9水平明显高于其他亚型组,MBP水平明显高于小动脉闭塞型卒中(SAO)组、其他病因组及不明原因组(均P<0.05); 心源性脑栓塞(CE)组CXCL16水平明显高于SAO组,MBP、MMP-9水平明显高于SAO组、其他病因组及不明原因组(均P<0.05); SAO组CXCL16、MBP水平明显低于其他病因组及不明原因组,MMP-9水平明显高于其他病因组(均P<0.05); 其他病因组MBP水平明显高于不明原因组(P<0.05)。ROC曲线分析显示,血清CXCL16、MBP、MMP-9单项诊断早期ACI的曲线下面积(AUC)分别为0.814、0.838、0.808,三项联合诊断早期ACI的AUC为0.933,均具有较高的诊断效能。结论:ACI患者血清CXCL16、MBP、MMP-9水平均明显升高,且与TOAST分型密切相关,可作为临床早期诊断的检测指标。
Abstract:
Objective:To investigate the changes and clinical significance of serum CXC chemokine ligand 16(CXCL16),myelin basic protein(MBP)and matrix metalloproteinase-9(MMP-9)in patients with different types of acute cerebral infarction(ACI)after typing according to trial of org 10172 in acute stroke treatment(TOAST).Methods:137 patients with ACI were randomly selected as the observation group and 89 healthy people in the same period were selected as the control group.The levels of serum CXCL16,MBP and MMP-9 were compared between the two groups.ACI patients were classified according to TOAST,and the levels of serum CXCL16,MBP and MMP-9 in patients with different subtypes of ACI were compared.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of CXCL16,MBP and MMP-9 in ACI.Results:The levels of serum CXCL16,MBP and MMP-9 in the observation group were significantly higher than those in the control group(all P<0.05).The levels of serum CXCL16,MBP and MMP-9 in patients with different TOAST typing were significantly different(all P<0.05); the levels of CXCL16 and MMP-9 in LAA group were significantly higher than those in other subtypes,and the level of MBP was significantly higher than that in SAO group,other etiology group and unexplained group(all P<0.05); the levels of CXCL16,MBP and MMP-9 in CE group were significantly higher than those in SAO group,other etiology group and unexplained group(all P<0.05); the levels of CXCL16 and MBP in SAO group were significantly lower than those in other etiology group and unexplained group,and the level of MMP-9 was significantly higher than that in other etiology group(all P<0.05); the level of MBP in other etiology group was significantly higher than that in unexplained group(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum CXCL16,MBP and MMP-9 in the single diagnosis of early ACI were 0.814,0.838 and 0.808 respectively,and the AUC of the three combined diagnosis of early ACI was 0.933,and they all had high diagnostic efficiency.Conclusion:The levels of serum CXCL16,MBP and MMP-9 in patients with ACI are significantly increased,which is closely related to TOAST classification and can be used as a detection index for early clinical diagnosis.

参考文献/References:

[1] 闫伟华,伍 艳.急性脑梗死患者早期抑郁性障碍的临床特征及对其实施健康教育的效果[J].中国健康心理学杂志,2019,27(5):719-723.
[2] Xu J,Li P,He B,et al.A new three-dimensional co(ii)-mixed-ligand MOF: A protective effect against acute cerebral infarction by reducing the hs-CRP content and inflammatory response[J].Journal of Structural Chemistry,2020,61(7):1132-1137.
[3] 葛晓利,张新宇,刘 芳,等.低分子肝素治疗进展性卒中疗效与安全性的系统评价[J].临床药物治疗杂志,2020,18(9):15-21.
[4] Deguchi I,Osada T,Takao M.Prescription status of oral anticoagulants in patients with acute cerebral infarction with non-valvular atrial fibrillation at the time of stroke onset-science direct[J].Journal of Cardiology,2020,75(5):544-548.
[5] 郝泽林,吴建跃,滕振飞,等.急性脑梗死患者血清学指标与神经功能缺损和脑梗死体积及颈动脉斑块性质的相关性研究[J].中华全科医学,2020,18(11):1803-1806.
[6] 彭 雪,孟利芳,刘 昊,等.脑微出血患者血清基质金属蛋白酶-9与出血部位及严重程度的相关性[J].中华行为医学与脑科学杂志,2021,30(3):244-249.
[7] 张 瑞,尉灵芝.神经肌肉电刺激辅助治疗对脑梗死患者脑部血流、CXC型趋化因子配体16及神经细胞因子的影响[J].国际神经病学神经外科学杂志,2020,47(2):30-34.
[8] 肖 华,卓 芬,黄娟娟,等.血清神经元特异性烯醇化酶、淀粉样蛋白A及低氧诱导因子α对缺血性脑卒中患者预后的评估意义[J].中国临床医生杂志,2019,47(9):1056-1058.
[9] 张 鹏.缺氧缺血性脑病新生儿血清髓鞘碱性蛋白、神经元特异性烯醇化酶水平与病情严重程度相关性分析及预后评估价值[J].陕西医学杂志,2021,50(6):720-722.
[10] 时 晔,郭 伟,徐 博,等.急性脑梗死患者血浆神经元特异性烯醇酶和碱性髓鞘蛋白的动态变化及意义[J].中国综合临床,2008,24(4):349-351.
[11] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682.
[12] 王建峰,张晨红,王 婉.缺血性脑血管病相关危险因素分析和治疗后疗效观察[J].陕西医学杂志,2017,46(12):1765-1766.
[13] 何小辉,周 楷,孟召友,等.缺血性脑卒中患者颅内外动脉狭窄的分布及危险因素分析[J].局解手术学杂志,2019,28(3):192-196.
[14] 陈佳露,张 继.急性脑梗死影像因素评估近期预后的研究[J].实用放射学杂志,2021,37(2):188-190,198.
[15] 董 一,王静云,马 君,等.保元汤合血府逐瘀汤治疗气虚血瘀型急性脑梗死临床研究[J].陕西中医,2021,42(5):590-593.
[16] 甄志刚,张秋莲,张 生,等.急性缺血性脑卒中静脉溶栓患者预后与TOAST分型的相关性分析[J].现代中西医结合杂志,2019,28(31):64-68.
[17] 武晓玲,郝智军,杨金水,等.同型半胱氨酸水平与急性脑梗死TOAST分型及颈动脉斑块稳定性的相关性分析[J].中华老年心脑血管病杂志,2019,21(12):1249-1252.
[18] 高 华,李沛珊,裴 静,等.基质金属蛋白酶9和胱抑素C水平与急性脑梗死患者颈动脉粥样硬化斑块稳定性的关系研究[J].实用心脑肺血管病杂志,2018,26(1):34-37.
[19] 刘希奇,李孝庆,姚 彦,等.脑梗死患者血清CXCL-16、GDF-15、PLA2水平变化及意义[J].中国现代医学杂志,2019,29(15):36-40.
[20] 李 星,李 博,王伊龙.血清CXCL16、PLGF水平变化与脑梗死患者TOAST分型、预后的相关性[J].热带医学杂志,2019,19(9):1120-1122,1134.

相似文献/References:

[1]李福泰,姚春虹△,慕廷民,等.急性脑梗死患者炎症因子与同型半胱氨酸、纤维蛋白原相关性研究*[J].陕西医学杂志,2019,(1):71.
　LI Futai,YAO Chunhong,MU Tingmin,et al.Correlation study between inflammatory factors andhomocysteine and fibrinogen in acute cerebral infarction patients[J].,2019,(12):71.
[2]袁山旗,赵红敏△,张西安,等.机械支架介入取栓联合静脉溶栓治疗老年急性脑梗死临床疗效 及对患者神经功能的影响[J].陕西医学杂志,2019,(2):237.
　YUAN Shanqi,ZHAO Hongmin,ZHANG Xian,et al.Clinical study of mechanical stent intervention and thrombectomy combined with arteriovenous thrombolysis in〖JP〗 the treatment of acute cerebral infarction in the elderly and its effect on neurological function[J].,2019,(12):237.
[3]冯金艳,邱丽华.MRI检查对颈动脉粥样硬化斑块的诊断价值研究*[J].陕西医学杂志,2019,(4):467.
　FENG Jinyan,QIU Lihua..Diagnostic value of MRI examination for carotid atherosclerotic plaques[J].,2019,(12):467.
[4]陆俊杰,张 洋,张清清,等.经微导管注射替罗非班联合Solitaire支架取栓治疗急性脑梗死21例临床研究*[J].陕西医学杂志,2019,(6):740.
[5]廖 涛,刘 超△.触珠蛋白与急性脑梗死患者病情程度及预后相关性分析[J].陕西医学杂志,2020,49(10):1292.[doi:DOI:10.3969/j.issn.1000-7377.2020.10.024]
[6]俞 茜,冯天保,王晓慧,等.磁共振成像平扫、磁敏感加权成像诊断急性脑梗死临床价值对比研究[J].陕西医学杂志,2021,50(4):425.[doi:DOI:10.3969/j.issn.1000-7377.2021.04.010]
[7]包 蕾.阿加曲班联合阿司匹林治疗急性脑梗死疗效及对患者血管内皮功能的影响[J].陕西医学杂志,2021,50(5):603.[doi:DOI:10.3969/j.issn.1000-7377.2021.05.022]
　BAO Lei.Efficacy of agatroban combined with aspirin in treatment of acute cerebral infarction[J].,2021,50(12):603.[doi:DOI:10.3969/j.issn.1000-7377.2021.05.022]
[8]薛亚妮,刘 瑞,陈 彭,等.依达拉奉注射液联合阿替普酶静脉溶栓治疗急性脑梗死临床疗效观察[J].陕西医学杂志,2021,50(6):731.[doi:DOI:10.3969/j.issn.1000-7377.2021.06.023]
[9]姜 飞,王东玉.依达拉奉右莰醇联合尿激酶静脉溶栓治疗急性脑梗死合并糖尿病对患者血清氧化应激水平、颈总动脉内-中膜厚度、血清基质金属蛋白酶-12水平的影响[J].陕西医学杂志,2022,51(1):88.[doi:DOI:10.3969/j.issn.1000-7377.2022.01.023]
　JIANG Fei,WANG Dongyu.Effects of edaravone dexborneol combined with urokinase intravenous thrombolysis on serum oxidative stress,common carotid artery intra-media thickness and serum MMP-12 in patients with acute cerebral infarction and diabetes mellitus[J].,2022,51(12):88.[doi:DOI:10.3969/j.issn.1000-7377.2022.01.023]
[10]王俐慧,苏东风,隋汝波.急性脑梗死患者血清miR-34b表达及检测临床意义[J].陕西医学杂志,2022,51(5):608.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.022]
　WANG Lihui,SU Dongfeng,SUI Rubo.Expression of miR-34b in serum of patients with acute cerebral infarction and its clinical significance[J].,2022,51(12):608.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.022]

备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2018SF-169)
更新日期/Last Update: 2021-12-07