【摘要】 目的 探讨急性脑梗死(ACI)患者血清凝集素-1(ITLN-1)、双重特异性磷酸酶1(DUSP1)、Krüpple样转录因子14(KLF14)水平与溶栓前美国国立卫生研究院卒中量表(NIHSS)评分及静脉溶栓后血管再闭塞的关系。方法 选取2021年6月至2025年6月张家口市第一医院收治的172例ACI患者作为研究对象,根据溶栓后是否发生血管再闭塞分为未再闭塞组和再闭塞组。检测所有研究对象血清ITLN-1、DUSP1、KLF14水平,收集所有研究对象基线资料。采用Pearson相关分析ACI发生血管再闭塞患者血清ITLN-1、DUSP1、KLF14水平与溶栓前NIHSS评分的相关性;采用多因素Logistic回归分析ACI患者发生血管再闭塞的影响因素;绘制受试者工作特征(ROC)曲线分析血清ITLN-1、DUSP1、KLF14单独及三者联合对ACI患者发生血管再闭塞的预测价值;采用相对危险度分析血清ITLN-1、DUSP1、KLF14水平与ACI患者发生血管再闭塞的关系。结果 未再闭塞组130例,再闭塞组42例。再闭塞组溶栓前NIHSS评分高于未再闭塞组,差异有统计学意义(P<0.05)。再闭塞组血清ITLN-1、DUSP1、KLF14水平均低于未再闭塞组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,ACI发生血管再闭塞患者血清ITLN-1、DUSP1、KLF14水平与溶栓前NIHSS评分均呈负相关(r=-0.486、-0.490、-0.473,P<0.05)。多因素Logistic回归分析结果显示,血清ITLN-1、DUSP1、KLF14水平升高均为ACI患者发生血管再闭塞的保护因素(P<0.05),溶栓前NIHSS评分升高为ACI患者发生血管再闭塞的危险因素(P<0.05)。ROC曲线分析结果显示,血清ITLN-1、DUSP1、KLF14单独预测ACI患者发生血管再闭塞的曲线下面积(AUC)分别为0.860、0.868、0.865,三者联合检测预测ACI患者发生血管再闭塞的AUC为0.976,血清ITLN-1、DUSP1、KLF14联合检测的AUC大于单独预测的AUC (Z=3.962、3.790、3.906,P<0.001)。相对危险度分析结果显示,血清ITLN-1、DUSP1、KLF14高表达ACI患者发生血管再闭塞分别是血清ITLN-1、DUSP1、KLF14低表达ACI患者发生血管再闭塞的0.121、0.147、0.159倍(P<0.05)。结论 ACI患者血清ITLN-1、DUSP1、KLF14水平均降低,与溶栓前NIHSS评分具有一定相关性,且ITLN-1、DUSP1、KLF14均对静脉溶栓后血管再闭塞具有一定辅助预测价值。更多还原

【Abstract】 Objective To investigate the relationship between the levels of serum lectin-1(ITLN-1),dual specific phosphatase 1(DUSP1) and Krüpple-like transcription factor 14(KLF14) and the national institutes of health stroke scale(NIHSS) score before thrombolysis as well as vascular reocclusion after intravenous thrombolysis in patients with acute cerebral infarction(ACI).Methods A total of 172 patients with ACI admitted to Zhangjiakou First Hospital from June 2021 to June 2025 were selected as the research objects.According to whether vascular reocclusion occurred after thrombolysis,they were divided into non-reocclusion group and reocclusion group.The serum ITLN-1,DUSP1 and KLF14 levels of all subjects were detected,and the baseline data of all subjects were collected.Pearson correlation analysis was used to analyze the correlation between serum ITLN-1,DUSP1,KLF14 levels and NIHSS score before thrombolysis in ACI patients with vascular reocclusion.Multivariate Logistic regression was used to analyze the influencing factors of vascular reocclusion in patients with ACI.The receiver operating characteristic(ROC) curve was drawn to analyze the predictive value of serum ITLN-1,DUSP1 and KLF14 alone and in combination for vascular reocclusion in patients with ACI.Relative risk was used to analyze the relationship between serum ITLN-1,DUSP1,KLF14 levels and vascular reocclusion in patients with ACI.Results There were 130 patients in the non-reocclusion group and 42 patients in the reocclusion group.The NIHSS score before thrombolysis in the reocclusion group before thrombolysis was significantly higher than that in the non-reocclusion group(P <0.05).The serum levels of ITLN-1,DUSP1 and KLF14 in the reocclusion group were lower than those in the non-reocclusion group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that serum ITLN-1,DUSP1,KLF14 levels were negatively correlated with NIHSS score before thrombolysis in ACI patients with vascular reocclusion(r= -0.486,-0.490,-0.473,P<0.05).Multivariate Logistic regression analysis showed that the increase of serum ITLN-1,DUSP1 and KLF14 levels were protective factors for vascular reocclusion in patients with ACI(P<0.05),and the increase of NIHSS score before thrombolysis was a risk factor for vascular reocclusion in patients with ACI(P<0.05).ROC curve analysis showed that the area under the curve(AUC) of serum ITLN-1,DUSP1 and KLF14 for predicting vascular reocclusion in patients with ACI was 0.860,0.868 and 0.865 respectively.The AUC of combined detection of the three indicators for predicting vascular reocclusion in patients with ACI was 0.976.The AUC of combined detection of serum ITLN-1,DUSP1,and KLF14 was greater than that of individual prediction(Z=3.962,3.790,3.906,P<0.001).Relative risk analysis showed that the incidence of vascular reocclusion in ACI patients with high expression of serum ITLN-1,DUSP1,and KLF14 was 0.121,0.147,and 0.159 times higher than that in ACI patients with low expression of serum ITLN-1,DUSP1,and KLF14(P<0.05).Conclusion The serum levels of ITLN-1,DUSP1 and KLF14 in ACI patients are decreased,which are correlated with the NIHSS score before thrombolysis ITLN-1,DUSP1 and KLF14 all have certain auxiliary predictive value for vascular reocclusion after intravenous thrombolysis.更多还原