血清OX40和OX40配体在老年急性脑梗死病人中的表达及临床意义

doi:10.3969/j.issn.1003-9198.2021.12.015

摘要/Abstract

摘要： 目的探讨血清OX40和OX40配体(OX40L)在老年急性脑梗死病人中的表达及临床意义。方法选取2018～2019年本院146例老年急性脑梗死病人(观察组)和50例健康老年人(对照组)作为研究对象,检测其血清OX40和OX40L水平。采用NIHSS评价急性脑梗死病人神经功能缺损情况,并将其分为轻度缺损组(n=32)、中度缺损组(n=72)和重度缺损组(n=42)。出院3个月时,采用改良Rankin量表(mRS)对老年脑梗死病人的预后进行评价,并将病人分为预后良好组(n=97)和预后不良组(n=49)。相关性分析采用Pearson相关分析;影响因素采用Logistic回归分析,并绘制ROC曲线分析血清OX40和OX40L预测预后的价值。结果轻度缺损组、中度缺损组、重度缺损组血清OX40和OX40L水平均高于对照组(P＜0.05),且病情越重,OX40和OX40L水平越高(P＜0.05)。NIHSS评分与OX40、OX40L均呈正相关(r分别为0.578和0.701,P＜0.05)。预后不良组血清OX40、OX40L水平均高于预后良好组(P＜0.05)。多因素Logistic回归分析显示,OX40、OX40L为老年急性脑梗死病人预后的独立影响因素(P＜0.05)。ROC曲线分析结果显示,OX40、OX40L预测病人预后的AUC分别为0.793和0.854,二者联合检测可将AUC提高至0.914。结论 OX40和OX40L与老年急性脑梗死病人神经功能缺损严重程度有关,并且有助于早期预测临床预后。

关键词: OX40, OX40配体, 急性脑梗死, 神经功能缺损, 预后

Abstract: Objective To explore the expression and clinical significance of serum OX40 and OX40 ligand (OX40L) in the elderly patients with acute cerebral infarction. Methods A total of 146 elderly patients with acute cerebral infarction (observation group) and 50 healthy elderly (control group) in our hospital from January 2018 to December 2019 were selected, and the serum levels of OX40 and OX40L were detected. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the neurological impairment, and the patients with acute cerebral infarction were divided into mild impairment group (n=32), moderate impairment group (n=72) and severe impairment group (n=42) according to the NIHSS scores. Three months after discharge, the modified Rankin Scale (mRS) was used to evaluate the prognosis of the elderly patients with cerebral infarction, and the patients were divided into good prognosis group (n=97) and poor prognosis group (n=49). Pearson test and Logistic regression were used for correlation analysis. Receiver operating characteristic (ROC) curve was drawn to analyze the prognostic value of serum OX40 and OX40L. Results The levels of serum OX40 and OX40L in mild impairment group, moderate impairment group and severe impairment group were higher than those in the control group (P<0.05); The levels of OX40 and OX40L increased with the increasing severity of the disease(P<0.05). NIHSS scores were positively correlated with the levels of OX40 and OX40L (r were 0.578 and 0.701 respectively, P＜0.05). The levels of serum OX40 and OX40L in the poor prognosis group were higher than those in the good prognosis group (P<0.05). Multivariate Logistic regression analysis showed that OX40 and OX40L were the independent risk factors for the prognosis of the elderly patients with acute cerebral infarction (P<0.05).ROC curve showed that the AUC of OX40 and OX40L for predicting the prognosis of patients was 0.793 and 0.854, respectively. The combined detection of the two indexes could increase the AUC to 0.914. Conclusions OX40 and OX40L are related to the severity of neurological deficit in the elderly patients with acute cerebral infarction, and can be used to predict the early clinical prognosis.

Key words: OX40, OX40 ligand, acute cerebral infarction, neurological deficit, prognosis

中图分类号:

R 743.3

时岩, 臧艳静, 王素玉, 刘树理. 血清OX40和OX40配体在老年急性脑梗死病人中的表达及临床意义[J]. 实用老年医学, 2021, 35(12): 1269-1272.

SHI Yan, ZANG Yan-jing, WANG Su-yu, LIU Shu-li. Expression and clinical significance of serum OX40 and OX40 ligand in the elderly patients with acute cerebral infarction[J]. Practical Geriatrics, 2021, 35(12): 1269-1272.

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