血清褪黑素、细胞角蛋白-18裂解片段水平与急性脑梗死患者预后的关系

目的探讨急性脑梗死(ACI)患者血清褪黑素、细胞角蛋白-18裂解片段(CCCK-18)水平及其预后的关系。方法选取2017年1月至2019年10月在重庆市巴南区人民医院行介入治疗的ACI患者136例,对治疗后患者进行为期3个月的随访,根据改良Rankin评分表(mRS)评分将患者分为预后良好组(50例)与预后不良组(86例);同时,选择同期体检健康人群100例作为对照组。检测及比较各组血清褪黑素、CCCK-18水平差异。应用多因素Logistic回归分析影响ACI患者预后的危险因素;绘制受试者工作特征(ROC)曲线分析血清褪黑素、CCCK-18水平对ACI患者预后的预测价值。结果ACI组患者血清褪黑素、CCCK-18水平高于对照组,差异有统计学意义(P<0.05);预后不良组血清褪黑素、CCCK-18水平、美国国立卫生院评分神经功能缺损(NIHSS评分)均高于预后良好组,发病至溶栓时间长于预后良好组,差异均有统计学意义(P<0.05)。ACI患者血清褪黑素、CCCK-18水平与NIHSS评分均呈正相关(r=0.458、0.513,P<0.05)。多因素Logistic回归分析结果显示,血清褪黑素和CCCK-18水平升高是影响ACI患者预后不良的重要危险因素(P<0.05)。血清褪黑素、CCCK-18及联合检测预测ACI患者预后不良的曲线下面积分别为0.873、0.858、0.945。结论血清褪黑素、CCCK-18水平升高与ACI患者的预后不良有关,联合检测血清褪黑素、CCCK-18对判断ACI患者的预后状态具有重要临床价值。

Relationship between serum melatonin and CCCK-18 levels and prognosis of patients with acute cerebral infarction

Objective To investigate the relationship between serum melatonin,cytokeratin-18 cleavage fragment(CCCK-18)levels and prognosis in patients with acute cerebral infarction(ACI).Methods A total of 136 patients with ACI who underwent interventional therapy in People′s Hospital of Chongqing Banan District from January 2017 to October 2019 were selected.After a 3-month follow-up,the patients were divided into good prognosis group(50 cases)and poor prognosis group(86 cases)according to Modified Rankin Scale(mRS)score.At the same time,100 healthy people were selected as the control group during the same period.Multivariate Logistic regression analysis was used to determine the risk factors for the prognosis of ACI patients.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum melatonin and CCCK-18 levels in the prognosis of ACI patients.Results The levels of serum melatonin and CCCK-18 in the ACI group were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of serum melatonin,CCCK-18,the NIH Stroke Scale(NIHSS)score were higher than those in the good prognosis group,and time from onset to thrombolysis in the poor prognosis group was longer than those in the good prognosis group,and the differences were statistically significant(P<0.05).The levels of serum melatonin and CCCK-18 in ACI patients were positively correlated with NIHSS scores(r=0.458,0.513,P<0.05).Multivariate Logistic regression analysis showed that elevated serum melatonin and CCCK-18 levels were important risk factors affecting the poor prognosis of ACI patients(P<0.05).The area under curve of single and combined detection of serum melatonin and CCCK-18 for predicting patients with poor prognosis were 0.873,0.858,0.945,respectively.Conclusion Elevated levels of serum melatonin and CCCK-18 are related to the poor prognosis of ACI patients.The combined detection of serum melatonin and CCCK-18 is of great clinical value in judging the prognosis status of ACI patients.