血清H-FABP、Ang-1在急性大血管闭塞性卒中静脉溶栓桥接支架取栓患者预后评估价值

doi:10.3969/j.issn.1000-8535.2023.08.007

广州医药 ›› 2023, Vol. 54 ›› Issue (8): 40-45.DOI: 10.3969/j.issn.1000-8535.2023.08.007

血清H-FABP、Ang-1在急性大血管闭塞性卒中静脉溶栓桥接支架取栓患者预后评估价值

吴肖锋, 陈丽薇, 张浩

黄河三门峡医院神经内科（三门峡 472000）

收稿日期:2023-01-06 出版日期:2023-08-20 发布日期:2023-09-13
基金资助:
中国水利水电第十一工程局有限公司科技项目[2021-（217）]

Prognostic value of serum H-FABP and Ang-1 in patients with ALS-LVO undergoing venous thrombolytic bridging stent thrombectomy

WU Xiaofeng, CHEN Liwei, ZHANG Hao

Department of Neurology,Sanmenxia Hospital of Yellow River,Sanmenxia 472000,China

Received:2023-01-06 Online:2023-08-20 Published:2023-09-13

摘要/Abstract

摘要： 目的探讨血清心型脂肪酸结合蛋白（H-FABP）、血管生成素-1（Ang-1）在急性大血管闭塞性卒中（AIS-LVO）静脉溶栓桥接支架取栓患者预后中的评估价值。方法选择2019年1月—2021年5月80例AIS-LVO患者作为研究对象,均接受静脉溶栓桥接支架取栓治疗,检测术前血清H-FABP、Ang-1水平,术后随访90 d将患者分为预后良好组（n=57）与预后不良组（n=23）。结果两组在高血压、冠心病、心房颤动、急性卒中治疗低分子肝素试验（TOAST）分型、侧支循环、术前H-FABP、术前Ang-1方面存在差异（P<0.05）。多因素 Logistic 回归分析结果显示,高血压、心房颤动、心源性梗死型、侧支循环为0 ~1 级、术前H-FABP≥10.0 ng/L、术前Ang-1<5.25 ng/mL是AIS-LVO静脉溶栓桥接支架取栓患者预后不良的危险因素。术前血清H-FABP预测术后90 d预后不良的AUC为0.728（95%CI：0.368~0.918）,灵敏度、特异度分别为66.68%、58.92%。术前血清Ang-1预测术后90 d预后不良的AUC为0.773（95%CI：0.592~1.129）,灵敏度、特异度分别为70.35%、63.92%。H-FABP联合Ang-1预测术后90 d预后不良的AUC为0.854（95%CI：0.652~0.957）,灵敏度、特异度分别为77.18%、71.82%。结论静脉溶栓桥接支架取栓治疗AIS-LVO患者的预后受到多种危险因素的影响,其中术前血清H-FABP和Ang-1是具有前景的预后预测因子。

关键词: 急性大血管闭塞性卒中, 心型脂肪酸结合蛋白, 血管生成素-1, 预后评估, 静脉溶栓, 桥接支架取栓

Abstract: Objective To investigate the prognostic value of serum heart-type fatty acid binding protein（H-FABP）and angiopoietin-1（Ang-1）in patients with acute ischemic stroke-large vessel occlusion（ALS-LVO）undergoing venous thrombolytic bridging stent thrombectomy．Methods A total of 80 patients with ALS-LVO from January 2019 to May 2021 were selected as the study subjects,treated with intravenous thrombolytic bridging stent thrombectomy,and their serum H-FABP and Ang-1 levels were measured before operation．After 90 days of follow-up,the patients were divided into good prognosis group（n=57）and poor prognosis group（n=23）．Results There were significant differences between the two groups in hypertension,coronary heart disease,atrial fibrillation,TOAST classification,collateral circulation,preoperative H-FABP,and preoperative Ang-1（P<0.05）．Multivariate logistic regression analysis showed that hypertension,atrial fibrillation,cardiogenic infarction type,collateral circulation of 0~1 grade,preoperative H-FABP≥10.0 ng/L,preoperative Ang-1<5.25 ng/mL were independent risk factors for poor prognosis of ALS-LVO patients treated with venous thrombolytic bridging stents．The AUC of preoperative serum H-FABP predicting poor prognosis 90 days after operation was 0.728（95%CI：0.368~0.918）,with sensitivity and specificity of 66.68% and 58.92% respectively．The AUC of preoperative serum Ang-1 predicting poor prognosis 90 days after surgery was 0.773（95%CI：0.592~1.129）,with sensitivity and specificity of 70.35% and 63.92% respectively．The AUC predicted by H-FABP combined with Ang-1 for poor prognosis 90 days after operation was 0.854（95%CI：0.652~0.957）,and the sensitivity and specificity were 77.18% and 71.82% respectively．Conclusions The prognosis of patients with ALS-LVO treated with intravenous thrombectomy bridging stent thrombectomy is affected by many risk factors,among which preoperative serum H-FABP and Ang-1 are promising prognostic factors．

Key words: acute ischemic stroke-large vessel occlusion, heart type fatty acid binding protein, angiopoietin-1, prognostic evaluation, venous thrombolysis, bridging stent thrombectomy

吴肖锋, 陈丽薇, 张浩. 血清H-FABP、Ang-1在急性大血管闭塞性卒中静脉溶栓桥接支架取栓患者预后评估价值[J]. 广州医药, 2023, 54(8): 40-45.

WU Xiaofeng, CHEN Liwei, ZHANG Hao. Prognostic value of serum H-FABP and Ang-1 in patients with ALS-LVO undergoing venous thrombolytic bridging stent thrombectomy[J]. Guangzhou Medical Journal, 2023, 54(8): 40-45.

参考文献

[1] MENON B K,AL-AJLAN F S,NAJM M,et al.Association of clinical,imaging,and thrombus characteristics with recanalization of visible intracranial occlusion in patients with acute ischemic stroke[J].JAMA,2018,320(10):1017-1026.
[2] 国家卫生健康委脑卒中防治工程委员会,中华医学会神经外科学分会神经介入学组,中华医学会放射学分会介入学组,等.急性大血管闭塞性缺血性卒中血管内治疗中国专家共识(2019年修订版)[J].中华神经外科杂志,2019,35(9):868-879.
[3] 刘相应,唐良秋,范文茂,等.直接经皮冠状动脉介入治疗术前、术后血清心型脂肪酸结合蛋白水平与急性ST段抬高心肌梗死患者预后的相关性[J].中国介入心脏病学杂志,2016,24(8):433-438.
[4] 闫薪如,冯娟.血清血管生成素1水平与急性脑梗死发病、病情严重程度及90d 预后的关系[J].临床神经病学杂志,2016,29(2):113-116.
[5] 陶鹏辉.Hs-CRP,CTnⅠ,H-FABP及VEGF-B对急性心肌梗死早期诊断的临床价值[J].实验与检验医学,2017,35(4):585-588.
[6] WUNDERLICH M T,HANHOFF T,GRTLER M,et al.Release of brain-type and heart-type fatty acid-binding proteins in serum after acute ischaemic stroke[J].J Neurol,2005,252(6):718-724.
[7] 吴芳,刘悦,蔡志友.急性脑梗死患者神经功能缺损程度与血清H-FABP、CD62P水平的关系[J].卒中与神经疾病,2018,25(2):142-145,149.
[8] 张旭,南京柱.血清hFABP,hs-CRP及Hcy水平在脑梗死患者中的诊断价值[J].北华大学学报(自然科学版),2022,23(2):225-229.
[9] AN S A,KIM J,KIM O J,et al.Limited clinical value of multiple blood markers in the diagnosis of ischemic stroke[J].Clin Biochem,2013,46(9):710-715.
[10] 陈芳,杨红燕,李学英.脑梗死患者合并无症状心肌缺血的临床分析[J].中国医药指南,2014,12( 36):183-184.
[11] 王延,钱海兵.Ang-1/Tie-2信号通路与缺血性脑卒中的相关性研究述评[J].中国中医基础医学杂志,2021,27(1):170-172,177.
[12] 陈秀英,左旭政,程畅,等.血清SDF-1,Ang-1与急性缺血性脑卒中预后的关系及其预测价值[J].卒中与神经疾病,2020,27(2):166-170,184.
[13] 方丽萍,傅阳俊,彭俊,等.血管生成素-1与急性缺血性脑卒中患者预后的关系[J].中华神经医学杂志,2018,17(10):1041-1044.
[14] 傅阳俊,方丽萍,彭俊,等.血管生成素1与急性缺血性卒中患者侧支循环的关系[J].中国脑血管病杂志,2018,15(8):408-413.

血清H-FABP、Ang-1在急性大血管闭塞性卒中静脉溶栓桥接支架取栓患者预后评估价值

Prognostic value of serum H-FABP and Ang-1 in patients with ALS-LVO undergoing venous thrombolytic bridging stent thrombectomy

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