血清神经元PAS结构域蛋白4、膜联蛋白A2、血小板内皮细胞黏附分子-1水平与急性脑梗死患者静脉溶栓预后的关系OA
Relationship between serum levels of neuronal PAS domain protein 4,Annexin A2,platelet endothelial cell adhesion molecule-1 and prognosis of intravenous thrombolysis in patients with acute cerebral infarction
目的 探讨神经元PAS结构域蛋白4(NPASDP4)、膜联蛋白A2(Annexin A2)、血小板内皮细胞黏附分子-1(PECAM-1)与急性脑梗死(ACI)患者静脉溶栓预后的关系.方法 选取117例接受溶栓治疗的ACI患者作为ACI组,另选取同期100例健康体检者作为对照组,比较2组血清NPASDP4、Annexin A2、PECAM-1水平.根据溶栓治疗后3个月改良Rankin量表(mRS)评分,将ACI患者分为预后不良组(n=38,3～6分)和预后良好组(n=79,0～2分),比较2组患者的临床资料.采用多因素Logistic回归分析筛选ACI患者预后不良的影响因素,通过受试者工作特征(ROC)曲线评估单一及联合指标对预后的预测价值.结果 ACI组血清NPASDP4、Annexin A2、PECAM-1水平均高于对照组,差异有统计学意义(P＜0.05).预后不良组患者入院时美国国立卫生院卒中量表(NIHSS)评分和血清NPASDP4、Annexin A2、PECAM-1水平均高于预后良好组,差异有统计学意义(P＜0.05).多因素Logistic回归分析显示,入院时NIHSS评分升高及血清NPASDP4、Annexin A2、PECAM-1水平升高是ACI患者预后不良的独立危险因素(P＜0.05).ROC曲线分析结果显示,血清NPASDP4、Annexin A2、PECAM-1三者联合预测ACI患者预后的曲线下面积为0.900,灵敏度为89.47％,特异度为88.61％,优于各指标单独检测的预测效能(P＜0.05).结论 ACI患者血清Annexin A2、NPASDP4、PECAM-1水平均显著升高,且预后不良患者水平高于预后良好患者.血清NPASDP4、Annexin A2、PECAM-1水平升高均为ACI患者静脉溶栓预后不良的危险因素,三者联合检测具有较高的预后预测价值.
Objective To investigate the relationship between neuronal PAS domain protein 4(NPASDP4),Annexin A2,platelet endothelial cell adhesion molecule-1(PECAM-1)and the prog-nosis of intravenous thrombolysis in patients with acute cerebral infarction(ACI).Methods A total of 117 ACI patients who received thrombolytic therapy were selected as ACI group,and 100 healthy individuals who underwent physical examinations during the same period were selected as control group.The serum levels of NPASDP4,Annexin A2,and PECAM-1 in the two groups were com-pared.According to the modified Rankin Scale(mRS)score 3 months after thrombolytic therapy,ACI patients were divided into poor prognosis group(n=38,3 to 6 points)and good prognosis group(n=79,0 to 2 points).The clinical data of the two groups were compared.Multivariate Logistic regression analysis was used to screen the influencing factors for poor prognosis in ACI pa-tients.The predictive value of single and combined indicators for prognosis was evaluated by the re-ceiver operating characteristic(ROC)curve.Results The serum levels of NPASDP4,Annexin A2,and PECAM-1 in the ACI group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The National Institutes of Health Stroke Scale(NIHSS)score at admission and the serum levels of NPASDP4,Annexin A2,and PECAM-1 in the poor prog-nosis group were higher than those in the good prognosis group,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that an increased NIHSS score at admission and elevated serum levels of NPASDP4,Annexin A2,and PECAM-1 were inde-pendent risk factors for poor prognosis in ACI patients(P＜0.05).ROC curve analysis showed that the area under the curve for the combined prediction of prognosis in ACI patients by serum NPASDP4,Annexin A2,and PECAM-1 was 0.900,with a sensitivity of 89.47％and a specificity of 88.61％,which was superior to the predictive efficacy of each indicator alone(P＜0.05).Conclusion The serum levels of Annexin A2,NPASDP4,and PECAM-1 in ACI patients are significantly increased,and the levels in patients with poor prognosis are higher than those in patients with good prognosis.Elevated serum levels of NPASDP4,Annexin A2,and PECAM-1 are risk factors for poor prognosis of intravenous thrombolysis in ACI patients,and the combined detection of the three indicators has a high predictive value for prognosis.
王浩然;郝智军;李景莉;周娜
中国人民解放军32153部队,河北 张家口,075100||中国人民解放军陆军第八十一集团军医院,急诊科,河北 张家口,075100中国人民解放军陆军第八十一集团军医院,神经内科,河北 张家口,075100中国人民解放军陆军第八十一集团军医院,神经内科,河北 张家口,075100湖南中医药大学第一附属医院胃肠外科,湖南长沙,410007
医药卫生
急性脑梗死静脉溶栓预后神经元PAS结构域蛋白4膜联蛋白A2血小板内皮细胞黏附分子-1生物标志物多因素Logistic回归分析
acute cerebral infarctionintravenous thrombolysisprognosisneuronal PAS do-main protein 4Annexin A2platelet endothelial cell adhesion molecule-1biomarkersmultivari-ate Logistic regression analysis
《实用临床医药杂志》 2026 (7)
14-18,5
国家自然科学基金项目(8211035231)湖南省卫生健康委科研计划项目(C202302088588)
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