| 陈俊霖.血清能量平衡相关蛋白、核因子红系相关因子2水平对急性大脑中动脉闭塞性卒中不良预后有预测效能[J].内科急危重症杂志,2026,32(4):378-382 |
| 血清能量平衡相关蛋白、核因子红系相关因子2水平对急性大脑中动脉闭塞性卒中不良预后有预测效能 |
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| DOI：10.11768/nkjwzzzz.202501080041 |
| 中文关键词: 大脑中动脉闭塞性急性缺血性卒中 能量平衡相关蛋白 核因子红系2相关因子2 预后 |
| 英文关键词: Middle cerebral artery occlusion-induced acute ischemic stroke Atropine Nuclear factor erythroid 2-related factor 2 Prognosis |
| 基金项目:四川省卫生健康科研课题项目(20PJ311) |
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| 中文摘要: |
| 摘要 目的：探讨血清能量平衡相关蛋白（Adropin）、核因子红系相关因子2（Nrf2）水平与大脑中动脉闭塞性急性缺血性卒中（MCAO-AIS）患者预后的关系。方法：选取MCAO-AIS患者206例（MCAO-AIS组）和100例体检健康者（对照组），根据改良Rankin量表对1年内预后情况进行评分，将MCAO-AIS组分为预后不良亚组（≥3分）71例和预后良好亚组（<3分）135例。采用酶联免疫吸附法检测并比较2组受试者血清Adropin、Nrf2水平。通过Logistic回归分析血清Adropin、Nrf2水平与MCAO-AIS患者不良预后的关系，Pearson法分析血清Adropin、Nrf2水平与高血压、糖尿病的相关性，Spearman法分析血清Adropin、Nrf2水平与美国国立卫生研究院卒中量表（NIHSS）评分、发病到再通时间、穿刺到再通时间的相关性，采用受试者工作特征（ROC）曲线分析血清Adropin、Nrf2水平对MCAO-AIS患者不良预后的预测价值。结果：与对照组比较，MCAO-AIS组血清Adropin、Nrf2水平降低（P均＜0.05）。206例MCAO-AIS患者1年内不良预后发生率为34.47%（71/206）。伴糖尿病、NIHSS评分、发病到再通时间为MCAO-AIS患者不良预后的危险因素；血清Adropin、Nrf2水平为保护因素（P均＜0.05）。Pearson/Spearman分析显示，MCAO-AIS患者血清Adropin、Nrf2水平与NIHSS评分呈负相关（P＜0.05），与高血压、糖尿病、发病到再通时间、穿刺到再通时间无关（P均＞0.05）。血清Adropin联合Nrf2预测MCAO-AIS患者不良预后的曲线下面积（AUC）为0.867，单独预测的AUC分别为0.787、0.790（P＜0.05）。结论：MCAO-AIS预后不良患者血清Adropin、Nrf2水平降低，且血清Adropin联合Nrf2检测可能对MCAO-AIS患者不良预后有预测效能。 |
| 英文摘要: |
| Abstract Objective: To explore the correlation between serum energy balance-related protein Adropin, nuclear factor erythroid 2-related factor 2 (Nrf2) levels and the prognosis of patients with middle cerebral artery occlusion-induced acute ischemic stroke (MCAO-AIS). Methods: A total of 206 patients with MCAO-AIS (MCAO-AIS group) and 100 healthy subjects undergoing physical examinations (control group) were enrolled. Based on the 1-year prognostic scores assessed by the modified Rankin Scale (mRS), the MCAO-AIS group was subdivided into a poor prognosis subgroup (score≥3, 71 cases) and a good prognosis subgroup (score <3, 135 cases). Enzyme-linked immunosorbent assay (ELISA) was adopted to detect and compare serum Adropin and Nrf2 levels between the two groups. Logistic regression analysis was performed to analyze the association of serum Adropin and Nrf2 levels with poor prognosis in MCAO-AIS patients. Pearson correlation analysis was used to evaluate the correlations of serum Adropin and Nrf2 levels with hypertension and diabetes mellitus, while Spearman correlation analysis was applied to assess their correlations with National Institutes of Health Stroke Scale (NIHSS) score, onset-to-recanalization time and puncture-to-recanalization time. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of serum Adropin and Nrf2 levels for poor prognosis in MCAO-AIS patients. Results Serum Adropin and Nrf2 levels were significantly lower in the MCAO-AIS group than in the control group (all P< 0.05). The 1-year incidence of poor prognosis among the 206 MCAO-AIS patients was 34.47% (71/206). Diabetes mellitus, higher NIHSS scores and prolonged onset-to-recanalization time were independent risk factors for poor prognosis in MCAO-AIS patients, whereas elevated serum Adropin and Nrf2 levels were protective factors (all P< 0.05). Pearson and Spearman correlation analyses revealed that serum Adropin and Nrf2 levels were negatively correlated with NIHSS scores (P< 0.05), and had no significant correlations with hypertension, diabetes mellitus, onset-to-recanalization time or puncture-to-recanalization time (all P> 0.05). The area under the ROC curve (AUC) of combined serum Adropin and Nrf2 for predicting poor prognosis in MCAO-AIS patients was 0.867, higher than the AUC of Adropin alone (0.787) and Nrf2 alone (0.790) (P< 0.05). Conclusion Patients with MCAO-AIS and poor prognosis present decreased serum Adropin and Nrf2 levels. Combined detection of serum Adropin and Nrf2 has potential predictive efficacy for poor prognosis in patients with MCAO-AIS. |
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