中国全科医学2018，Vol.21Issue(9)：1053-1059,7.DOI:10.3969/j.issn.1007-9572.2018.00.067
趋化因子CXCL12和可溶性血管细胞黏附因子1对短暂性脑缺血发作后短期缺血性脑卒中发生风险的预测价值研究
Predictive Value of Chemokine CXCL12 and sVCAM-1 on the Short-term Risk of Ischemic Stroke after Transient Ischemic Attack
摘要
Abstract
Objective To determine the predictive value of chemokine CXCL12 and sVCAM-1 in predicting the short-term incidence of ischemic stroke (within 7 days) after transient ischemic attack (TIA). Methods We recruited 104 cases of TIA treated in Department of Neurology, Binzhou Medical University Hospital from July 2015 to February 2017. We collected their baseline characteristics, detected the serum levels of chemokine CXCL12 and sVCAM-1 and assigned 25 of them with ischemic stroke within 7 days after TIA to ischemic stroke group, and other 79 without to non-ischemic stroke group. The value of ABCD2score, chemokine CXCL12, sVCAM-1 and chemokine CXCL12 combined with sVCAM-1for predicting the short-term incidence of ischemic stroke after TIA was analysed. Results The average levels of Hcy, chemokine CXCL12 and sVCAM-1 as well as average ABCD2score of ischemic stroke patients were significantly higher than those of non-ischemic stroke patients (P<0.05). Multivariate Logistic regression analysis showed that hemokine CXCL12〔OR=1.454, 95% CI (1.133, 1.866)〕and sVCAM-1〔OR=1.008, 95% CI (1.003, 1.014)〕were risk factors for ischemic stroke shortly after TIA (P<0.05). The levels of hemokine CXCL12 and sVCAM-1 increased with the growth of ABCD2score, namely, the levels of chemokine CXCL12 and sVCAM-1 increased successively in patients with ABCD2score of 0-3 (low-risk of ischemic stroke), ABCD2score of 4-5 (medium-risk of ischemic stroke) and ABCD2score of 6-7 (high-risk of ischemic stroke) (P<0.05). For predicting the short-term incidence of ischemic stroke after TIA, the AUC of ABCD2score was 0.778〔95% CI (0.671, 0.886), the cut-off value was 4.5, sensitivity was 72.0%, specificity was 72.2%〕; the AUC of chemokine CXCL12 was 0.909〔95% CI (0.850, 0.968), the cut-off value was 9.6 μg/L, sensitivity was 76.0%, specificity was 91.1%〕; the AUC of sVCAM-1 was 0.875〔95% CI (0.781, 0.968), the cut-off value was 682.7 μg/L, sensitivity was 84.0%, specificity was 87.3%〕; the AUC of chemokine CXCL12 combined with sVCAM-1 was 0.878〔95% CI (0.799, 0.956) , the cut-off values were 9.6 μg/L and 682.7 μg/L, sensitivity was 92.0%, specificity was 83.5%〕. Conclusion Both chemokine CXCL12 and sVCAM-1 are important biological markers for predicting the short-term incidence of ischemic stroke in patients after TIA, which deserve to be widely used in clinical practice.关键词
脑卒中/缺血发作,短暂性/趋化因子CXCL12/可溶性血管细胞黏附因子1/预测Key words
Stroke/Ischemic attack,transient/Chemokine CXCL12/Soluble vasccular cell adhesion molecule 1/Forecasting分类
医药卫生引用本文复制引用
曹晓雨,刘庆新,李莎,徐静,侯一玮..趋化因子CXCL12和可溶性血管细胞黏附因子1对短暂性脑缺血发作后短期缺血性脑卒中发生风险的预测价值研究[J].中国全科医学,2018,21(9):1053-1059,7.基金项目
山东省医药卫生科技发展计划项目(2013WS0309) （2013WS0309）
