临床神经病学杂志2025，Vol.38Issue(3)：161-166,6.
血清富含亮氨酸α2糖蛋白1、解偶联蛋白2、Sestrin2联合评估急性缺血性脑卒中患者认知状态及预后的临床意义
Clinical significance of serum leucine-rich α-2-glycoprotein 1,uncoupling protein 2 and sestrin2 in evaluating the cognitive status and prognosis of acute ischemic stroke patients
摘要
Abstract
Objective To investigate the clinical value of serum leucine-rich α-2-glycoprotein 1(LRG1),uncoupling protein 2(UCP2)and sestrin2 in evaluating the cognitive status and prognosis of patients with acute ischemic stroke(AIS).Methods A total of 164 AIS patients who were treated and hospitalized in the Department of Neurology of our hospital from April 2020 to May 2023 were selected as the study subjects.According to the Chinese version of the Montreal cognitive assessment scale(MoCA),the patients were divided into cognitive impairment group and non-cognitive impairment group.The levels of serum LRG1,UCP2 and Sestrin2 were compared between the two groups.Pearson correlation analysis was used to test the correlation between serum LRG1,UCP2 and Sestrin2 and MoCA score.After discharge,the patients were followed up for 3 months.The mRS was used to divide the patients into poor prognosis group and good prognosis group.The data and serum levels of LRG1,UCP2 and Sestrin2 were compared between the two groups.Multivariate Logistic regression analysis was used to explore the prognostic factors of AIS patients.ROC curve was constructed to evaluate the predictive efficacy of serum LRG1,UCP2 and Sestrin2 alone and in combination on cognitive status and prognosis of AIS patients.Results There were 115 cases in the non-cognitive impairment group and 49 cases in the cognitive impairment group.The serum levels of LRG1 and UCP2 in the non-cognitive impairment group were significantly higher than those in the cognitive impairment group,while the Sestrin2 level was significantly lower than that in the cognitive impairment group(all P＜0.05).Serum LRG1 and UCP2 levels were positively correlated with MoCA score,while Sestrin2 level was negatively correlated with MoCA score(all P＜0.05).The area under the curve(AUC)of serum LRG1,UCP2 and Sestrin2 in cognitive status of AIS patients was 0.723,0.689 and 0.789,respectively,while the AUC of the combined detection of the three reached 0.892,and the 95％CI of the AUC of all indicators did not contain 0.5(all P＜0.05).There were 134 cases in the good prognosis group and 30 cases in the poor prognosis group.The NIHSS score,mRS score and Sestrin2 level in the good prognosis group were significantly lower than those in the poor prognosis group,while the MoCA score,LRG1 and UCP2 levels were significantly higher than those in the poor prognosis group(all P＜0.05).The increase of NIHSS score(OR=1.419),mRS score(OR=1.153)and serum Sestrin2 level(OR=1.462)were risk factors affecting the prognosis of AIS patients,while the increase of MoCA score(OR=0.657),serum LRG1 level(OR=0.756)and UCP2 level(OR=0.733)were protective factors affecting the prognosis of AIS patients(all P＜0.05).From the AUC value,the combination of the three(0.899)was significantly higher than Sestrin2(0.755),LRG1(0.730)and UCP2(0.712).The combination of sensitivity,specificity and Youden index was also significantly higher than other single indicators(all P＜0.05).Conclusion The combined detection of serum LRG1,UCP2 and Sestrin2 shows higher efficiency than single detection in the evaluation of cognitive status and prognosis of AIS patients,and its AUC,sensitivity,specificity and other indicators are better,providing more accurate and reliable evaluation basis for clinical practice.关键词
富含亮氨酸α2糖蛋白1/解偶联蛋白2/Sestrin2/急性缺血性脑卒中/认知状态/预后Key words
leucine-rich α-2-glycoprotein 1/uncoupling protein 2/sestrin2/acute ischemic stroke/cognitive state/prognosis分类
临床医学引用本文复制引用
吴洪霞,杨红丽,陈锋,刘万萍,张惠,雷阳..血清富含亮氨酸α2糖蛋白1、解偶联蛋白2、Sestrin2联合评估急性缺血性脑卒中患者认知状态及预后的临床意义[J].临床神经病学杂志,2025,38(3):161-166,6.基金项目
2023四川省级科技计划项目(2023NSFSC1595) （2023NSFSC1595）
