本文已被:浏览 208次 下载 196次
Received:July 03, 2023 Published Online:April 20, 2024
Received:July 03, 2023 Published Online:April 20, 2024
中文摘要: 目的 探讨脑血流动力学和血清吲哚胺2,3-双加氧酶(IDO)与卒中后认知障碍(PSCI)的相关性,探索IDO对PSCI的预测价值。
方法 选取2020年7月至2021年6月于联勤保障部队第九〇〇医院神经内科明确诊断的发病不超过7 d的50例急性缺血性脑卒中患者作为病例组,根据是否患有PSCI分为PSCI组(n=30)和无PSCI(PSNCI)组(n=20),并选取同期50例健康体检者作为对照组(n=50)。采用ELISA检测入组人群的血清IDO水平。行经颅彩色多普勒超声(TCCD)屏气试验,并记录相关数据,计算屏气指数(BHI)作为脑血流动力学的评价指标。ROC曲线分析IDO水平对PSCI的诊断效能。
结果 三组间血清D-二聚体、N末端B型利钠肽〖JP2〗前体(NT-proBNP)水平差异有统计学意义(P<0.05)。对照组、PSNCI组和PSCI组的血清IDO水平分别为(0.23±〖JP〗0.05)、(0.25±0.02)和(0.31±0.03)ng/mL,三组间差异有统计学意义(F=41.092, P<0.01);与PSNCI组比较,PSCI组IDO水平增高(P<0.05),D-二聚体、NT-proBNP水平差异无统计学意义(P>0.05)。三组间BHI差异无统计学意义(P>0.05)。PSCI组与PSNCI组病灶部位的差异无统计学意义(χ2=15.478, P=0.113)。IDO 水平截断值为0.277 ng/mL时对PSCI的预测效能最高,ROC曲线下面积(AUC)为0.938,灵敏度为83.3%,特异度为95.0%。
结论 血清IDO水平与PSCI有显著相关性,然而血流动力学指标与PSCI发生的关系尚不明确。急性缺血性卒中后早期进行IDO水平的检测有助于PSCI的早期识别与诊治。
中文关键词: 脑血流动力学 吲哚胺2,3-双加氧酶 缺血性脑卒中 卒中后认知障碍 屏气指数 D-二聚体 N末端B型利钠肽前体
Abstract:Objective To investigate the correlation between cerebral hemodynamics, serum indoleamine 2,3-dioxygenase (IDO) and post-stroke cognitive impairment (PSCI), and to explore the predictive value of IOD for PSCI.
Methods A total of 50 patients with acute ischemic stroke who were diagnosed and the onset being not more than 7 days in the Department of Neurology of the 900th Hospital of PLA Joint logistics Support Force from July 2020 to June 2021 were selected as the case group. According to the presence or absence of PSCI, the patients were divided into PSCI group (n=30) and non-PSCI (PSNCI) group (n=20), and 50 healthy individuals during the same period were selected as the control group (n=50). ELISA was used to detect the serum IDO levels of the enrolled population. Transcranial color Doppler ultrasound (TCCD) breath-holding test was performed and relevant data was recorded, breath holding index (BHI) was calculated as an evaluation index of cerebral hemodynamics. ROC curve was used to analyze the predictive efficacy of IDO level on PSCI.
Results There were statistically significant differences in serum levels of D-dimer and N-terminal pro-brain natriuretic peptide (NT-proBNP) among the three groups (P<0.05). The serum IDO levels in the control group, PSNCI group, and PSCI group were (0.23±0.05), (0.25±0.02), and (0.31±0.03) ng/mL, respectively, with statistically significant differences among the three groups (F=41.092, P<0.01). Compared with the PSNCI group, the PSCI group showed an increase in IDO levels (P<0.05), while there was no statistically significant difference in D-dimer and NT-proBNP levels (P>0.05). There was no significant difference in BHI among the three groups (P>0.05). No significant difference was found in lesion location between the PSCI group and the PSNCI group (χ2=15.478, P=0.113). The predictive efficacy was highest when the IDO level cutoff value was 0.277 ng/mL, with a area under the ROC curve (AUC) of 0.938, sensitivity of 83.3%, and specificity of 95.0%.
Conclusion There is a significant correlation between serum IDO levels and PSCI, but the relationship between hemodynamic indicators and the occurrence of PSCI is still unclear. Early detection of IDO levels after acute ischemic stroke is helpful for the early identification and diagnosis of PSCI.
keywords: Cerebral hemodynamics Indoleamine 2,3-dioxygenase Ischemic stroke Post-stroke cognitive impairment Breath holding index D-dimer N-terminal pro-brain natriuretic peptide
文章编号: 中图分类号:R743.3 R749.1 文献标志码:A
基金项目:福建省自然科学基金项目(2022J011093);第九〇〇医院临床应用研究专项(2020L23)
引用文本: