血清UCP2、脑组织净水摄取率、入院时NIHSS评分、ASPECTS评分对急性大血管闭塞性脑卒中机械取栓术后发生恶性脑水肿的预测价值OA
The predictive value of serum UCP2,brain tissue clean water uptake rate,NIHSS score at admission and ASPECTS score for malignant cerebral edema in patients with acute large vessel occlusive stroke after mechanical thrombectomy
目的 探讨血清解偶联蛋白2(UCP2)联合脑组织净水摄取率(NWU)、入院时美国国立卫生研究院卒中量表(NIHSS)评分、Alberta卒中项目早期CT(ASPECTS)评分对急性大血管闭塞性脑卒中(AIS-LVO)机械取栓术后发生恶性脑水肿(MCE)的预测价值.方法 选取2022年5月至2025年1月在该院进行机械取栓术治疗的300例AIS-LVO患者作为研究对象,根据术后MCE的发生情况将患者分为MCE组和非MCE组.检测所有患者术前血清UCP2水平,完善颅脑CT检查获得NWU.采用多因素Logistic回归分析AIS-LVO患者机械取栓术后发生MCE的关联因素.采用受试者工作特征(ROC)曲线分析入院时NIHSS评分、ASPECTS评分、NWU及血清UCP2对AIS-LVO患者机械取栓术后发生MCE的预测价值.结果 MCE组血清UCP2水平低于非MCE组,NWU高于非MCE组,差异均有统计学意义(P＜0.05).MCE组年龄及梗死体积大于非MCE组,入院时NIHSS评分高于非MCE组,术后ASPECTS评分低于非MCE组,差异均有统计学意义(P＜0.05).多因素Logistic回归分析结果显示,入院时NIHSS评分、NWU、血清UCP2及 AS-PECTS 评分是AIS-LVO患者机械取栓术后发生MCE的关联因素(P＜0.05).ROC曲线分析结果显示,4项指标联合预测AIS-LVO患者机械取栓术后发生MCE的曲线下面积(AUC)为0.943,大于入院时NIHSS评分、ASPECTS 评分、UCP2、NWU 单独预测的 AUC(Z=5.225、5.043、4.276、4.892,均 P＜0.05).结论 NWU、入院时NIHSS评分、ASPECTS评分及血清UCP2与AIS-LVO患者机械取栓后MCE的发生有关,4项指标联合在MCE风险预测中具有较高的效能.
Objective To investigate the predictive value of serum uncoupling protein 2(UCP2)combined with brain tissue water uptake rate(NWU),National Institutes of Health Stroke Scale(NIHSS)score at ad-mission,Alberta Stroke Program Early CT(ASPECTS)score for malignant cerebral edema(MCE)in pa-tients with acute large vessel occlusive stroke(ASI-LVO)after mechanical thrombectomy.Methods A total of 300 patients with AIS-LVO who underwent mechanical thrombectomy in the hospital from May 2022 to January 2025 were selected as the research objects.According to the occurrence of postoperative MCE,the pa-tients were divided into MCE group and non-MCE group.The serum UCP2 levels of all patients were detected before operation,and the brain CT examination was performed to obtain NWU.Multivariate Logistic regres-sion was used to analyze the related factors of MCE after mechanical thrombectomy in patients with AIS-LVO.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of NIHSS score at admission,ASPECTS score,NWU and serum UCP2 for MCE in patients with ASI-LVO after me-chanical thrombectomy.Results The serum UCP2 level in the MCE group was lower than that in the non-MCE group,and the NWU was higher than that in the non-MCE group,and the differences were statistically significant(P＜0.05).The age and infarct size of the MCE group were larger than those of the non-MCE group,the NIHSS score at admission was higher than that of the non-MCE group,and the postoperative AS-PECTS score was lower than that of the non-MCE group,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that NIHSS score at admission,NWU,serum UCP2 and ASPECTS score were related factors of MCE after mechanical thrombectomy in patients with ASI-LVO(P＜0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of the com-bination of 4 indicators for predicting MCE after mechanical thrombectomy in patients with AIS-LVO was 0.943,which was larger than the AUC predicted by NIHSS score at admission,ASPECTS score,UCP2 and NWU alone(Z=5.225,5.043,4.276,4.892;all P＜0.05).Conclusion NWU,NIHSS score at admission,ASPECTS score and serum UCP2 are related to the occurrence of MCE in patients with ASI-LVO after me-chanical thrombectomy.The combination of the 4 indicators has a high efficacy in predicting the risk of MCE.
李巍;李书成;刘柯婷
四川省成都市第七人民医院神经内科,四川成都 611100四川省成都市第七人民医院神经内科,四川成都 611100四川省成都市第七人民医院神经内科,四川成都 611100
医药卫生
急性大血管闭塞性脑卒中机械取栓术恶性脑水肿解偶联蛋白2脑组织净水摄取率
acute large vessel occlusion strokemechanical thrombectomymalignant brain edemauncoupling protein 2brain tissue clean water uptake rate
《检验医学与临床》 2026 (9)
1183-1189,7
四川省卫生健康委员会科研课题项目(20PJ219).
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