血清OX40L、Occludin与急性缺血性脑卒中患者病情程度及预后的相关性

目的探讨急性缺血性脑卒中患者血清OX40配体(OX40L)、闭合蛋白(Occludin)的水平,分析其与患者病情严重程度及预后的关系。方法选取2016年1月至2020年1月在该院接受治疗的135例急性缺血性脑卒中患者为观察组。另选取同期该院体检健康者100例为对照组。采用酶联免疫吸附试验检测血清OX40L、Occludin水平差异。患者出院后6个月采用改良Rankin量表(mRS)评估预后状况,并分为预后良好组93例(mRS评分≤2分)和预后不良组42例(mRS评分>2分)。采用多因素Logistic回归分析影响急性缺血性脑卒中患者预后不良的危险因素。结果观察组血清OX40L、Occludin水平与对照组相比,差异有统计学意义(P<0.05)。急性缺血性脑卒中重度组血清OX40L、Occludin水平高于中度组、轻度组,中度组血清OX40L、Occludin水平高于轻度组,差异有统计学意义(P<0.05)。预后不良组血清OX40L、Occludin水平明显高于预后良好组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,美国国立卫生研究院卒中量表(NIHSS)评分及血清OX40L、Occludin水平升高是影响急性缺血性脑卒中患者不良预后的独立危险因素(P<0.05)。受试者工作特征(ROC)曲线结果示,血清OX40L、Occludin及二者联合检测预测急性缺血性脑卒中患者不良预后的AUC分别为0.834、0.800、0.912。结论急性缺血性脑卒中患者血清OX40L、Occludin水平明显升高,与患者神经功能缺损程度及预后情况密切相关,联合检测血清OX40L、Occludin可作为急性缺血性脑卒中患者预后状况辅助生物学指标。

Correlation between serum OX40L,Occludin and the severity and prognosis of patients with acute ischemic stroke

Objective To investigate the serum OX40 ligand(OX40L)and occludin(Occludin)levels in patients with acute ischemic stroke,and analyze their relationship with the severity and prognosis of patients.Methods A total of 135 cases of acute ischemic stroke treated in Department of Neurology of Cangzhou Central Hospital from January 2016 to January 2020 were selected as the observation group.During the same period,another 100 healthy volunteers for physical examination in our hospital were selected as the control group.The enzyme-linked immunosorbent assay was used to detect the difference in serum OX40L and Occludin levels.Six months after discharge,the patients were assessed with the mRS scale for prognosis and were divided into a good prognosis group of 93 cases(mRS score≤2 points)and a poor prognosis group of 42 cases(mRS score>2 points).Multivariate Logistic regression was used to analyze the risk factors affecting the poor prognosis of patients with acute ischemic stroke.Results Compared with the control group,the serum OX40L and Occludin levels in the observation group were significantly different(P<0.05).The levels of serum OX40L and Occludin in the severe acute ischemic stroke group were higher than those in the moderate group and the mild group,and the levels of serum OX40L and Occludin in the moderate group were higher than those in the mild group,and the differences were statistically significant(P<0.05).The levels of serum OX40L and Occludin in the poor prognosis group were significantly higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).The results of multivariate analysis showed that NIHSS score and increased serum OX40L and Occludin levels were independent risk factors affecting the poor prognosis of patients with acute ischemic stroke(P<0.05).ROC curve results showed that the AUC of serum OX40L,Occludin and their combined detection to predict the poor prognosis of patients with acute ischemic stroke were 0.834,0.800,0.912,respectively.Conclusion The levels of serum OX40L and Occludin in patients with acute ischemic stroke are significantly increased,which are closely related to the degree of neurological impairment and prognosis.Combined detection of serum OX40L and Occludin could be used as auxiliary biological indicators for the prognosis of patients with acute ischemic stroke.