急性缺血性脑卒中静脉溶栓患者血清骨桥蛋白水平和临床短期预后的相关性研究

目的分析经重组组织型纤溶酶原激活剂(rt-PA)治疗后的急性缺血性脑卒中(AIS)患者血清骨桥蛋白水平与神经功能改善和预后的关系。方法选取2016-01-2019-01复旦大学附属金山医院收治的85例AIS患者,根据rt-PA治疗7 d后NIHSS评分较溶栓前的差值分为神经功能改善良好组(ΔNIHSS≥4分)和神经功能改善不良组(ΔNIHSS<4分),比较两组基本信息、血液生化指标和入院时NIHSS评分等。对单因素分析筛选出来可能影响患者早期神经功能改善的因素进一步行Logistic回归分析,分析血清骨桥蛋白水平与预后不良的关系。结果多因素Logistic回归分析显示年龄较大、NIHSS评分较高、低密度脂蛋白高和骨桥蛋白水平高是影响神经功能改善的危险因素(P<0.05)。治疗90 d后采用改良Rankin评分量表对患者情况分别评定。其中85例患者中,预后不良者为14例,预后良好者71例,后者的骨桥蛋白显著低于前者,差异有统计学意义(P<0.001)。结论血清骨桥蛋白水平可能可以作为预测AIS患者静脉溶栓治疗预后的一个重要参考指标。

Correlation study of serum osteopontin on short-term outcome in acute ischemic stroke patients treated with intravenous recombinant tissue plasminogen activator

Objective To analyze the relationship between serum osteopontin level and neurological function improvement and prognosis in patients with acute ischemic stroke(AIS)treated with recombinant tissue plasminogen activator(rt-PA).Methods 85 cases of patients with AIS were selected in Jin Shan Hospital affiliated to Fudan University,from January,2016 to January,2019.The scores of theΔNIHSS<4 was defined as poor prognosis and the scores ofΔNIHSS≥4 defined as excellent outcome after treatment of rt-PA 7 d comparing the NIHSS scores before and after the thrombolysis,and analyze the basic information,blood biochemical indexes of two groups and NIHSS score on admission,etc.Logistic regression analysis was carried out to analyze the factors that may affect the early improvement of neurological function of patients,screened out by univariate analysis,the relationship between serum osteopontin level and poor prognosis was analyzed.Results The multi-factor Logistic regression analysis showed that older,higher NIHSS score,low density lipoprotein and osteopontin level are the risk factors affecting neural function improvement(P<0.05).After 90 d of treatment,modified Rankin scale was used to evaluate the patients'conditions.Among the 85 patients,14 cases had a poor prognosis,71 cases had a good prognosis,and the osteopontin of the latter was significantly lower than that of the former,with statistically significant difference(P<0.001).Conclusion Serum osteopontin level may be an important factor for predicting prognosis of AIS patients after intravenous thrombolysis.