血清鸢尾素、泛连接蛋白1对丁苯酞序贯治疗缺血性脑卒中后再发的预测价值
Predictive value of serum irisin and pannexin 1 for recurrence after butylphthalide sequential therapy in ischemic stroke

袁帼彧.血清鸢尾素、泛连接蛋白1对丁苯酞序贯治疗缺血性脑卒中后再发的预测价值[J].内科急危重症杂志,2026,32(3):269-273

DOI：10.11768/nkjwzzzz20260313

中文关键词: 缺血性脑卒中丁苯酞序贯治疗再次脑血管事件泛连接蛋白1 鸢尾素

英文关键词:Ischemic stroke Butylphthalide Sequential therapy Recurrent cerebrovascular event Pannexin 1 Irisin

基金项目:河北省张家口市2024年市级科技计划自筹经费项目（2421091D）

作者	单位	E-mail
袁帼彧	张家口市第一医院神经内四科	pingmu420@163.com

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中文摘要:

摘要目的：探讨血清鸢尾素（irisin）、泛连接蛋白1（Panx-1）对丁苯酞序贯治疗的缺血性脑卒中（IS）患者再发的预测价值。方法；选取213例IS患者，均采取丁苯酞序贯治疗，依据1年后脑血管事件再发生（RCE）率分为脑卒中再发（RCE）组和脑卒中未再发（N-RCE）组。比较2组一般资料、治疗前、后常规实验室指标及血清irisin、Panx-1水平，采用Pearson法分析治疗后血清irisin、Panx-1与常规实验室指标相关性，采用LASSO交叉验证算法筛选指标，构建联合预测模型，绘制受试者工作特征（ROC）曲线，分析治疗后血清irisin、Panx-1与常规实验室指标对RCE发生的预测价值。结果：治疗前和治疗4、8周后，RCE组血Panx-1、白细胞计数（WBC）、C反应蛋白（CRP）、同型半胱氨酸（Hcy）、白介素-6（IL-6）水平高于N-RCE组，血irisin、血小板计数（PLT）低于N-RCE组（P均＜0.05）；治疗8周后，血irisin与WBC、CRP、Hcy、IL-6、Panx-1呈负相关，与PLT呈正相关（P均＜0.05）；血Panx-1与WBC、CRP、Hcy、IL-6呈正相关，与PLT呈负相关（P均＜0.05）；血 irisin、Panx-1、Hcy、IL-6入选预测模型，回归系数分别为-0.217、0.421、0.325、0.124。ROC曲线显示，预测模型在训练集和验证集的曲线下面积分别为0.935、0.934，明显高于单一指标预测（P均＜0.05）。结论：治疗8周后血清irisin、Panx-1是IS患者丁苯酞序贯治疗后RCE发生的重要预测因子，与Hcy、IL-6联合后预测性能更佳，有助于指导临床精准医疗。

英文摘要:

Abstract Objective: To explore the predictive value of serum irisin and pannexin 1 (Panx-1) for recurrent cerebrovascular events (RCE) in patients with ischemic stroke (IS) after butylphthalide sequential therapy. Methods: A total of 213 IS patients receiving butylphthalide sequential therapy were enrolled. According to the occurrence of RCE within one year, they were divided into RCE group and non-RCE (N-RCE) group. General data, routine laboratory indicators and serum levels of irisin and Panx-1 before and after treatment were compared between the two groups. Pearson correlation analysis was used to analyze the correlation of post-treatment irisin and Panx-1 with routine laboratory indicators. The LASSO cross-validation algorithm was applied to screen indicators and construct a combined prediction model. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of post-treatment serum irisin, Panx-1 and routine laboratory indicators for RCE. Results Before treatment and at 4 and 8 weeks after treatment, the levels of Panx-1, white blood cell count (WBC), C-reactive protein (CRP), homocysteine (Hcy) and interleukin-6 (IL-6) in the RCE group were higher than those in the N-RCE group, while irisin and platelet count (PLT) were lower (P< 0.05). At 8 weeks after treatment, serum irisin was negatively correlated with WBC, CRP, Hcy, IL-6 and Panx-1, and positively correlated with PLT (P< 0.05). Serum Panx-1 was positively correlated with WBC, CRP, Hcy and IL-6, and negatively correlated with PLT (P< 0.05). Irisin, Panx-1, Hcy and IL-6 were included in the prediction model, with regression coefficients of -0.217, 0.421, 0.325 and 0.124, respectively. ROC curve analysis showed that the area under the curve of the prediction model in the training set and validation set was 0.935 and 0.934 respectively, which was significantly higher than that of single indicator prediction (P< 0.05). Conclusion: Serum irisin and Panx-1 at 8 weeks after treatment are important predictive factors for RCE in IS patients treated with butylphthalide sequential therapy. The combined prediction with Hcy and IL-6 achieves better predictive performance, which is conducive to guiding clinical precise treatment.