天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (8): 828-832.doi: 10.11958/20190321

• 临床研究 • 上一篇    下一篇

血清TN-C和Irisin在H型高血压合并急性缺血性脑卒中患者中的临床意义

程启慧，余丹△，杨国帅，王良，符惠芳，刘春苗，周锋，周律   

  1. 海口市人民医院（中南大学湘雅医学院附属海口医院）神经内科（邮编570208）
  • 收稿日期:2019-01-31 修回日期:2019-05-21 出版日期:2019-08-15 发布日期:2019-08-16
  • 通讯作者: 程启慧 E-mail:tjxa16@163.com
  • 作者简介:程启慧（1974），男，硕士，副主任医师，主要从事认知障碍性疾病研究
  • 基金资助:
    海南省卫生计生行业科研项目

The clinical significance of serum levels of tenascin-C and irisin in patients with H-type hypertension complicated with acute ischemic stroke

CHENG Qi-hui, YU Dan△, YANG Guo-shuai, WANG Liang, FU Hui-fang, LIU Chun-miao, ZHOU Feng, ZHOU Lyu   

  1. Department of Neurology, Haikou People’s Hospital, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou 570208, China
  • Received:2019-01-31 Revised:2019-05-21 Published:2019-08-15 Online:2019-08-16

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摘要： 摘要：目的 探讨H型高血压合并急性缺血性脑卒中患者血清腱糖蛋白C（TN-C）和鸢尾素（Irisin）水平变化及与病情严重程度和预后的关系。方法 选取2017年6月—2018年9月本院神经内科诊治的126例H型高血压合并急性缺血性脑卒中患者作为病例组，选取同期63例H型高血压非急性缺血性脑卒中患者作为对照组。病例组根据入组时NIHSS评分分为轻症组（38例）、中症组（57例）和重症组（31例）；根据治疗90 d后mRS评分分为预后良好组（77例）和预后不良组（49例）。采用酶联免疫吸附试验（ELISA）检测研究对象血清TN-C和Irisin水平，分析血清TNC和Irisin水平与H型高血压合并急性缺血性脑卒中患者病情严重程度和预后的关系。应用受试者工作特征曲线（ROC）分析TN-C和Irisin在H型高血压合并急性缺血性脑卒中患者预后中的临床价值。结果 病例组患者血清TN-C水平高于对照组（P＜0.05）；而血清Irisin水平低于对照组（P＜0.05）。血清TN-C水平随病情严重程度增加而升高；而血清Irisin水平随病情严重程度增加而降低（P＜0.05）。预后良好组患者血清TN-C水平低于预后不良组（P＜0.05），而血清Irisin水平高于预后不良组（P＜0.05）。血清TN-C水平与NIHSS评分和mRS评分呈正相关（r 分别为0.579、0.603，P＜0.05）；血清Irisin水平与NIHSS评分和mRS评分呈负相关（rs 分别为-0.526、-0.497，P＜0.05）。TN-C和Irisin预测H型高血压合并急性缺血性脑卒中患者预后的曲线下面积分别为0.832、0.784，临界值为81.68μg/L和92.39 μg/L时，敏感度分别为69.4%、63.6%；特异度分别为85.7%、89.8%。结论 血清TN-C和Irisin参与H型高血压合并急性缺血性脑卒中发病过程，且与病情严重程度和预后相关，可作为患者病情严重程度和预后的评价指标。

关键词: 高血压, 脑缺血, 卒中, 腱糖蛋白C, 鸢尾素, 严重程度, 预后

Abstract: Abstract：Objective To investigate the relationship between the serum levels of tenascin-C (TN-C) and irisin and the severity and prognosis in patients with H-type hypertension complicated with acute ischemic stroke. Methods A total of 126 patients with H-type hypertension complicated with acute ischemic stroke hospitalized in our hospital from June 2017 to September 2018 were selected as case group, and 63 patients with H-type hypertension without acute ischemic stroke were selected as control group. According to NIHSS score at the time of admission, the case group was divided into mild group (n=38), moderate group (n=57) and severe group (n=31). According to mRS score 90 days after treatment, the case group was divided into good prognosis group (n=77) and poor prognosis group (n=49). Serum levels of TN-C and irisin were measured by ELISA method. The relationship between serum levels of TNC and irisin and the severity and prognosis of Htype hypertension complicated with acute ischemic stroke was analyzed. The clinical values of TN-C and irisin in the prognosis of patients with H-type hypertension complicated with acute ischemic stroke were analyzed by receiver operating curve (ROC). Results The serum level of TN-C was significantly higher in case group than that in control group (P＜0.05),while the serum level of irisin was significantly lower than that in control group (P＜0.05). The serum TN-C level increased with the severity of the disease, while the serum irisin level decreased with the severity of the disease (P＜0.05). The serum level of TN-C was lower in patients with good prognosis than that in patients with poor prognosis (P＜0.05) while the serum level of irisin was higher in patients with good prognosis than that in patients with poor prognosis (P＜0.05). The serum TNC level was positively correlated with NIHSS score and mRS score (r=0.579, 0.603, P＜0.05), while the serum irisin level was negatively correlated with NIHSS score and mRS score (rs=-0.526, -0.497, P＜0.05). The area under the curve of TN-C and irisin for predicting the prognosis of patients with H-type hypertension complicated with acute ischemic stroke were 0.832 and 0.784 respectively. When the cut-off values were 81.68 μg/L and 92.39 μg/L, the sensitivities were 69.4% and 63.6% respectively, and the specificities were 85.7% and 89.8% respectively. Conclusion The serum TN-C and irisin are involved in the pathogenesis of H-type hypertension complicated with acute ischemic stroke, and related to the severity and prognosis of the disease. They could be used as biomarkers for early evaluation of the severity and prognosis of the disease.

Key words: hypertension, cerebral ischemia, stroke, tenascin-C, irisin, severity, prognosis