目的 探讨酸性钙结合蛋白（S-100B）、脂蛋白相关磷脂酶A2（LP-PLA2）、环状RNA（circ_0021132）在急性脑梗死（ACI）中的表达及与复发的关系。方法 选取2019年1月—2020年10月我院ACI患者138例作为观察组,同期健康体检者99例作为对照组。对比两组血S-100B、LP-PLA2、circ_0021132水平,观察组随访1年记录ACI复发率,Cox回归法分析ACI复发相关因素,受试者工作特征曲线（ROC）分析S-100B、LP-PLA2、circ_0021132复发中的预测价值。结果 观察组治疗后较治疗前血清S-100B[（1.21±0.20）μg/L vs（1.53±0.25）μg/L]、LP-PLA2[（180.26±36.49）μg/L vs（238.72±49.75）μg/L]水平降低,circ_0021132[（1.61±0.18）vs（1.32±0.09）]水平升高,治疗前后血清S-100B、LP-PLA2水平均高于对照组[（1.04±0.17）μg/L、（103.51±32.42）μg/L],circ_0021132水平均低于对照组（1.98±0.13）;不同的脑梗死分型治疗后circ_0021132表达均升高;大动脉粥样硬化型、心源性栓塞型、小动脉闭塞型患者治疗前后circ_0021132均低于其他明确病因型、不明原因型;多因素Cox回归方程校正脑梗死体积、吸烟、颈动脉斑块、合并糖尿病、合并高脂血症后,服用抗血小板聚集药物情况、治疗后血清S-100B、LP-PLA2、circ_0021132水平仍是复发的独立影响因素;S-100B、LP-PLA2、circ_0021132联合预测ACI复发的AUC为0.897,最大约登指数对应的PI值为0.17;随PI值（<0.1、0.1~0.2、>0.2）增加,复发率（0 vs 9.84% vs 32.69%）呈增加趋势（P<0.05）。结论 ACI患者S-100B、LP-PLA2、circ_0021132表达异常,且是ACI复发的独立因素,联合检测可为临床评估ACI复发风险提供客观依据。
Abstract
Objective To explore the expression of acid calcium binding protein (S-100B), lipoprotein-associated phospholipase A2(LP-PLA2), and circular RNA (circ_0021132) in acute cerebral infarction (ACI) and their relationship with recurrence. Methods From January 2019 to October 2020, 138 patients with ACI in our hospital were selected as the observation group, and 99 patients with healthy physical examination during the same period were selected as the control group. The blood levels of S-100B, LP-PLA2, and circ_0021132 were compared between the two groups. The observation group was followed up for 1 year to record the ACI recurrence rate. Cox regression method was used to analyze the related factors of ACI recurrence. The receiver operating characteristic curve (ROC) was used to analyze the predictive value of S-100B, LP-PLA2, circ_0021132 in recurrence. Results Serum S-100B [(1.21±0.20) μg/L vs (1.53±0.25) μg/L] and LP-PLA2 [(180.26±36.49) μg/L vs (238.72±49.75) μg/L] levels in the observation group decreased after treatment, and circ_0021132 [(1.61±0.18) vs (1.32±0.09)] levels increased. Serum S-100B and LP-PLA2 levels before and after treatment were higher than those in the control group, and circ_0021132 levels were lower than those in the control group (P<0.05). The expression of circ_0021132 increased after treatment of different types of cerebral infarction (P<0.05). circ_0021132 of patients with large atherosclerosis, cardiogenic embolization and small artery occlusion were lower than those with other clear and unknown etiology (P<0.05). After adjusting for cerebral infarct volume, smoking, carotid plaque, diabetes mellitus and hyperlipidemia by multivariate Cox regression equation, anti-platelet aggregation drugs, serum S-100B, LP-PLA2, and circ_0021132 levels after treatment remained were independent influencing factors of recurrence (P<0.05). The AUC of S-100B, LP-PLA2, and circ_0021132 combined to predict the recurrence of ACI was 0.897, and the PI value corresponding to the maximum Youden index was 0.17. With the increase of PI value (<0.1, 0.1~0.2, >0.2), the recurrence rate (0 vs 9.84% vs 32.69%) showed an increasing trend. Conclusion S-100B, LP-PLA2, and circ_0021132 expressed abnormally in ACI patients, and they are independent factors of ACI recurrence. Combined detection can provide an objective basis for clinical assessment of the risk of ACI recurrence.
关键词
S-100B /
LP-PLA2 /
circ_0021132 /
急性脑梗死
Key words
S-100B /
LP-PLA2 /
circ_0021132 /
acute cerebral infarct
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基金
宝鸡市卫生健康委员会科研课题“血清MIF、NRG-1在颅脑损伤患者中的表达”（19WS012）
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