血浆细胞纤维连接蛋白动态检测在急性脑梗死预后判断中的价值

目的 探讨血浆细胞纤维连接蛋白(c-Fn)在急性脑梗死中的动态变化及其在预后判断中的意义.方法 采用酶联免疫吸附法动态检测66例急性脑梗死患者及40名正常对照者血浆c -Fn水平,根据美国国立卫生院神经功能缺损评分,分析其与病情和预后的相关性.并通过受试者工作特征(ROC)曲线判断预测急性脑梗死的血浆c-Fn最佳临界值.结果 急性脑梗死组入院时(24 h内)血浆c-Fn含量较对照组明显升高,差异有统计学意义(t=7.03,P＜0.05),随着病情变化c-Fn含量于伤后3～14 d出现逐渐降低、持续高值或继发性升高；预后不良组血浆c-Fn含量明显高于预后良好组,差异有统计学意义(t=5.46,P＜0.05),根据ROC曲线,初步得出血浆c-Fn浓度＞5.24μg/ml可作为预测急性脑梗死预后的临界值.结论 外周血血浆c-Fn水平变化情况有助于观察脑梗死患者病情的动态变化和判断预后.

Prognostic values of dynamically assaying cellular fibronectin in patients with acute ischemic stroke

Objective To investigate the changes and prognostic values of cellular fibronectin（c-Fn） in patients with acute ischemic stroke. Methods A total of 66 patients with acute ischemic stroke and 40 healthy subjects were selected. The plasma concentration of e-Fn was dynamically assayed by ELISA, and the relationship between state of illness and prognosis were evaluated by National Institutes of Health Stroke Scale （NIHSS）. And a specific concentration of plasma c- Fn for prognosis of acute isehemie stroke was estimated through the receiver operating characteristic （ROC） curve. Results The plasma concentration of c-Fn of experimental group were higher than that of the control group （t=7.03, P〈0.05）. With the developing of state of illness, the plasma concentration of c-Fn was gradually lower or at steadily high level or sec- ondary increased after 3-14 days. Compared with the favorable prognosis group, the levels of plasma c-Fn within 24 hours was significantly increased in poor prognosis group（t=5.46, P〈0.05）. According to the ROC curve, plasma c-Fn concentration 〉5.24 μg/ml was used to predict prognosis of acute iscbemic stroke. Conclusions The concentration of plasma c-Fn can predict the state of illness and prognosis of acute isehemic stroke.