脑小血管病总负荷联合血清8-OHDG、Ficolin-3对老年穿支动脉粥样硬化病预后的预测价值

doi:10.11958/20252920

天津医药 ›› 2026, Vol. 54 ›› Issue (6): 618-622.doi: 10.11958/20252920

脑小血管病总负荷联合血清8-OHDG、Ficolin-3对老年穿支动脉粥样硬化病预后的预测价值

曹阳(), 段朋仓, 李梦雨, 史方堃, 胡晨, 邢方圆, 李花莲

沧州市中心医院脑科医院脑血管病一科（邮编061000）

收稿日期:2025-09-16 修回日期:2025-12-31 出版日期:2026-06-15 发布日期:2026-06-15
作者简介:曹阳（1989），女，主治医师，主要从事脑血管病方面研究。E-mail：cao183yang@163.com
基金资助:
沧州市科技计划自筹经费项目(23244102080)

Predictive value of total load of cerebral small vessel disease combined with serum 8-OHDG and Ficolin-3 for prognosis in elderly patients with branch atheromatous disease

CAO Yang(), DUAN Pengcang, LI Mengyu, SHI Fangkun, HU Chen, XING Fangyuan, LI Hualian

Department of Cerebrovascular Diseases I, Neurology Hospital, Cangzhou Central Hospital, Cangzhou 061000, China

Received:2025-09-16 Revised:2025-12-31 Published:2026-06-15 Online:2026-06-15

曹阳, 段朋仓, 李梦雨, 史方堃, 胡晨, 邢方圆, 李花莲. 脑小血管病总负荷联合血清8-OHDG、Ficolin-3对老年穿支动脉粥样硬化病预后的预测价值[J]. 天津医药, 2026, 54(6): 618-622.

CAO Yang, DUAN Pengcang, LI Mengyu, SHI Fangkun, HU Chen, XING Fangyuan, LI Hualian. Predictive value of total load of cerebral small vessel disease combined with serum 8-OHDG and Ficolin-3 for prognosis in elderly patients with branch atheromatous disease[J]. Tianjin Medical Journal, 2026, 54(6): 618-622.

摘要/Abstract

摘要：

目的探究脑小血管病（CSVD）总负荷联合血清8-羟基-2-脱氧鸟苷（8-OHDG）、纤维凝胶蛋白3（Ficolin-3）对老年穿支动脉粥样硬化病（BAD）患者预后的预测价值。方法回顾性纳入BAD患者85例，采用改良Rankin量表（mRS）将就诊90 d后的患者分为预后良好组（52例）与预后不良组（33例）；Spearman法分析NIHSS评分与BAD患者CSVD总负担及血清8-OHDG、Ficolin-3水平的相关性；受试者工作特征（ROC）曲线分析CSVD总负担联合血清8-OHDG、Ficolin-3水平对BAD患者预后不良的预测效能；Logistic回归分析BAD患者预后不良的影响因素。结果与预后良好组比较，预后不良组CSVD总负荷3~4分人数占比更高，入院时NIHSS评分、8-OHDG水平较高，Ficolin-3水平较低（P<0.05）；BAD患者入院时NIHSS评分与CSVD总负荷、8-OHDG水平呈正相关，与Ficolin-3呈负相关（P<0.05）；CSVD总负荷、血清8-OHDG、Ficolin-3水平及三者联合预测BAD患者预后不良的曲线下面积（AUC）分别为0.793（95%CI：0.694~0.892）、0.713（95%CI：0.602~0.823）、0.735（95%CI：0.626~0.844）及0.875（95%CI：0.798~0.951），联合预测的效能高于单一指标（Z_{CSVD总负荷-联合预测}=2.231、Z_8-OHDG_-_联合预测=2.627、Z_Ficolin-3_-_联合预测=2.304，均P<0.05）；CSVD总负荷3~4分、高水平的8-OHDG、低水平的Ficolin-3是BAD患者入院90 d后预后不良的危险因素（P<0.05）。结论 CSVD总负荷联合血清8-OHDG、Ficolin-3水平可有效评估BAD患者预后情况。

关键词: 动脉粥样硬化, 8-羟基-2’-脱氧鸟苷, 预后, 穿支动脉粥样硬化病, 纤维凝胶蛋白3, 脑小血管病总负荷

Abstract:

Objective To investigate the predictive value of total cerebral small vessel disease (CSVD) burden combined with serum 8-hydroxydeoxyguanosine (8-OHDG) and Ficolin-3 for the prognosis of elderly patients with branch atheromatous disease (BAD). Methods A retrospective selection of 85 BAD patients treated at our hospital from April 2022 to October 2024 was conducted. Patients were divided into the good prognosis group (n=52) and the poor prognosis group (n=33) using the modified Rankin scale (mRS). Spearman's method was used to analyze the correlation between NIHSS scores and the total CSVD burden, as well as serum 8-OHDG and Ficolin-3 levels in BAD patients. Receiver operating characteristic (ROC) analysis was used to evaluate the predictive performance of the total CSVD burden combined with serum 8-OHDG and Ficolin-3 levels for poor prognosis in BAD patients. Logistic regression was used to analyze the factors associated with poor prognosis in BAD patients. Results The proportion of patients with a total CSVD burden score of 3- 4 was higher in the poor prognosis group than that in the good prognosis group. Compared with the good prognosis group, there were higher NIHSS scores and 8-OHDG levels, and lower Ficolin-3 level in the poor prognosis group (P<0.05). In BAD patients, NIHSS scores at admission were positively correlated with total CSVD burden and 8-OHDG levels, and negatively correlated with Ficolin-3 levels (P<0.05). The areas under the curve (AUC) for total CSVD burden, serum 8-OHDG, Ficolin-3 levels, and the combination of these three in predicting poor prognosis in BAD patients were 0.793（95%CI: 0.694-0.892), 0.713（95%CI: 0.602-0.823), 0.735（95%CI: 0.626-0.844) and 0.875（95%CI: 0.798-0.951), respectively, with the combined prediction showing higher accuracy than individual indicators (Z_{CSVD total burden-combined prediction} = 2.231, Z_{8-OHDG-combined prediction} = 2.627, Z_{Ficolin-3-combined prediction} = 2.304, all P<0.05). A total CSVD burden of 3-4 points, higher serum levels of 8-OHDG and low levels of Ficolin-3 were risk factors for poor prognosis in BAD patients 90 days after admission (P<0.05). Conclusion The combined assessment of total CSVD burden with serum 8-OHDG and Ficolin-3 levels can effectively evaluate the prognosis of BAD patients.

Key words: atherosclerosis, 8-hydroxydeoxyguanosine, prognosis, branch atheromatous disease, Ficolin-3, total burden of cerebral small vessel disease

中图分类号:

R543.5

图/表 5

参考文献 20

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组别		n	男性		年龄/岁		高血压		糖尿病		高脂血症		吸烟史	收缩压/mmHg
预后良好组		52	31（59.62）		68.13±7.71		36（69.23）		10（19.23）		15（28.85）		29（55.77）	160.42±16.82
预后不良组		33	19（57.58）		67.24±7.02		22（66.67）		6（18.18）		7（21.21）		20（60.61）	163.42±17.29
t或χ²			0.035		0.538		0.061		0.015		0.613		0.193	0.793
组别	舒张压/ mmHg			空腹血糖/ （mmol/L）		糖化血红蛋白/%		TC/ （mmol/L）		TG/ （mmol/L）		LDL-C/（mmol/L）			入院时 NIHSS/分
预后良好组	92.23±10.83			5.82±1.73		6.02±1.47		4.39±1.18		1.79±0.33		2.89±0.51			5.73±1.29
预后不良组	91.36±12.71			5.77±1.64		5.93±1.23		4.68±1.22		1.82±0.36		2.85±0.47			10.94±4.15
t	0.336			0.133		0.260		1.125		0.392		0.328			7.008^＊＊

组别		n	男性		年龄/岁		高血压		糖尿病		高脂血症		吸烟史	收缩压/mmHg
预后良好组		52	31（59.62）		68.13±7.71		36（69.23）		10（19.23）		15（28.85）		29（55.77）	160.42±16.82
预后不良组		33	19（57.58）		67.24±7.02		22（66.67）		6（18.18）		7（21.21）		20（60.61）	163.42±17.29
t或χ²			0.035		0.538		0.061		0.015		0.613		0.193	0.793
组别	舒张压/ mmHg			空腹血糖/ （mmol/L）		糖化血红蛋白/%		TC/ （mmol/L）		TG/ （mmol/L）		LDL-C/（mmol/L）			入院时 NIHSS/分
预后良好组	92.23±10.83			5.82±1.73		6.02±1.47		4.39±1.18		1.79±0.33		2.89±0.51			5.73±1.29
预后不良组	91.36±12.71			5.77±1.64		5.93±1.23		4.68±1.22		1.82±0.36		2.85±0.47			10.94±4.15
t	0.336			0.133		0.260		1.125		0.392		0.328			7.008^＊＊

组别	n	CSVD总负荷				8-OHDG/（ng/L）	Ficolin-3/（μg/L）
组别	n	1分	2分	3分	4分	8-OHDG/（ng/L）	Ficolin-3/（μg/L）
预后良好组	52	2（3.85）	30（57.69）	20（38.46）	0（0.00）	43.92±9.14	22.57±3.46
预后不良组	33	0（0.00）	5（15.15）	18（54.55）	10（30.30）	61.37±10.81	17.39±2.54
t或Z		27.068^＊＊				7.990^＊＊	7.947^＊＊

组别	n	CSVD总负荷				8-OHDG/（ng/L）	Ficolin-3/（μg/L）
组别	n	1分	2分	3分	4分	8-OHDG/（ng/L）	Ficolin-3/（μg/L）
预后良好组	52	2（3.85）	30（57.69）	20（38.46）	0（0.00）	43.92±9.14	22.57±3.46
预后不良组	33	0（0.00）	5（15.15）	18（54.55）	10（30.30）	61.37±10.81	17.39±2.54
t或Z		27.068^＊＊				7.990^＊＊	7.947^＊＊

指标	敏感度/ %	特异度/ %	截断值	AUC	95%CI	约登指数
CSVD总负荷	84.85	63.46	3.00分	0.793	0.694~0.892	0.483
8-OHDG	66.67	71.15	52.49 ng/L	0.713	0.602~0.823	0.378
Ficolin-3	66.67	69.23	20.14 μg/L	0.735	0.626~0.844	0.359
联合预测	90.91	61.54		0.875	0.798~0.951	0.525

脑小血管病总负荷联合血清8-OHDG、Ficolin-3对老年穿支动脉粥样硬化病预后的预测价值

Predictive value of total load of cerebral small vessel disease combined with serum 8-OHDG and Ficolin-3 for prognosis in elderly patients with branch atheromatous disease

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变量	β	SE	Wald χ²	P	OR	OR95%CI
CSVD总负荷	1.070	0.261	16.792	<0.001	2.914	1.747~4.860
8-OHDG	1.055	0.275	14.728	<0.001	2.873	1.676~4.925
Ficolin-3	-0.368	0.104	12.532	<0.001	0.692	0.564~0.848
常数项	-6.725	0.906	47.295	<0.001	0.005	-

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