| 8 | 0 | 9 |
| 下载次数 | 被引频次 | 阅读次数 |
目的 探究单核细胞趋化蛋白1(monocyte chemoattractant protein-1,MCP-1)、过氧化物酶体增殖物激活受体γ辅助激活因子1α(peroxisome proliferator-activated receptor gamma coactivator 1α,PGC-1α)、轴突生长导向因子1(netrin-1,NTN-1)与老年急性脑梗死（acute cerebral infarction,ACI）患者神经功能缺损程度及预后的关系。方法 前瞻性选取2023年12月至2024年12月南阳市第二人民医院收治的ACI患者118例为ACI组，另选取同期本院健康体检者60例作为对照组。依据美国国立卫生研究院卒中量表评分评估ACI患者神经功能缺损程度并分为轻度组（46例）、中度组（43例）和重度组（29例）。依据6个月随访结果将患者分为预后良好组76例和预后不良组42例，采用酶联免疫吸附法检测所有参与者血清MCP-1、PGC-1α、NTN-1水平。比较不同组患者血清中MCP-1、PGC-1α、NTN-1水平。多因素logistic回归分析ACI患者预后不良的影响因素。相对危险度分析血清MCP-1、PGC-1α、NTN-1不同水平对ACI患者预后不良的影响。采用ROC曲线分析MCP-1、PGC-1α、NTN-1对ACI患者预后的预测价值。结果 与对照组比较，ACI组血清MCP-1水平明显升高，血清PGC-1α、NTN-1水平明显降低（P<0.01）。轻、中、重度组神经功能缺损，ACI患者血清MCP-1水平逐渐明显升高，血清PGC-1α、NTN-1水平逐渐明显降低（P<0.05）。与预后良好组比较，预后不良组发病至入院时间及血清MCP-1水平升高，血清PGC-1α、NTN-1水平明显降低（P<0.05）。多因素logistic回归分析显示，发病至入院时间（OR=2.135,95%CI:1.293～3.526）、血清MCP-1(OR=7.341,95%CI:3.391～15.890)、PGC-1α(OR=0.172,95%CI:0.113～0.262)、NTN-1(OR=0.204,95%CI:0.140～0.297)水平是ACI患者预后不良的影响因素（P<0.01）。血清MCP-1高水平患者发生预后不良风险明显高于MCP-1低水平患者（P<0.01）;PGC-1α、NTN-1低水平患者发生预后不良的风险分别明显高于PGC-1α、NTN-1高水平患者（P<0.01）。血清MCP-1、PGC-1α、NTN-1联合预测ACI患者预后不良发生的价值优于单一指标（Z=2.227,P<0.05;Z=2.430,P<0.05;Z=2.642;P<0.01）。结论 ACI患者血清MCP-1水平升高，血清PGC-1α、NTN-1水平降低，与患者预后密切相关，血清MCP-1、PGC-1α、NTN-1联合预测ACI患者预后不良的价值较高。
Abstract：[1]Liu Y, Wang C, Han Y. Management of acute cerebral infarction by intravenous thrombolysis with recombinant T cell receptor and plasminogen activator and association of emergency nursing route in the prognosis[J]. Cell Mol Biol(Noisy-le-grand), 2023, 69(8):18-24. DOI:10.14715/cmb/2023.69.8.3.
[2]Meng H, Xing X, Zhang C, et al. Relations between antinuclear,antineutrophil cytoplasmic, anticardiolipin antibodies and degree of neurological deficit, cerebrovascular stenosis in cerebral infarction patients[J]. Pak J Med Sci, 2023, 39(3):677-681. DOI:10.12669/pjms.39.3.6765.
[3]Wang Q, Wang Y, Wang Y, et al. Impact of improved stroke green channel process on the delay of intravenous thrombolysis in patients with acute cerebral infarction during the COVID-19 pandemic:an observational study[J]. Front Neurol, 2022, 13:998134. DOI:10.3389/fneur.2022.998134.
[4]Henrich L, Kiessling I, Steimer M, et al. Circadian dependency of microglial heme oxygenase-1 expression and inflammation determine neuronal injury in hemorrhagic stroke[J]. J Inflamm(Lond), 2023,20(1):43. DOI:10.1186/s12950-023-00371-w.
[5]Han B, Jiang W, Cui P, et al. Microglial PGC-1α protects against ischemic brain injury by suppressing neuroinflammation[J]. Genome Med, 2021, 13(1):47. DOI:10.1186/s13073-021-00863-5.
[6]Chen Z, Cao T, Zhong X, et al. Association between serum netrin-1levels and early neurological deterioration after acute ischemic stroke[J]. Front Neurol, 2022, 13:953557. DOI:10.3389/fneur.2022.953557.
[7]中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志，2018,51(9):666-682. DOI:10.3760/cma.j.issn.1006-7876.2018.09.004.
[8]兰翠霞，王健，王江凤，等.血清Lp-PLA2、RDW-CV、NLR值变化与急性脑梗死患者早期神经功能恶化及预后的关系[J].中国现代医学杂志，2023,33(10):12-17. DOI:10.3969/j.issn. 1005-8982.2023.10.003.
[9]Mohamed WS, Kamel AE, Abdelwahab AH, et al. High neutrophil-to-lymphocyte ratio predicts early neurological deterioration in spontaneous intracerebral hemorrhage patients[J]. Egypt J Neurol Psychiatry Neurosurg, 2021, 57(1):29. DOI:10.1186/s41983-020-00267-z.
[10]Hao H, Xing X, Li Y, et al. Value evaluation of serum(sdLDLc*HCYc)/HDLc ratio in the stability of intracranial arterial plaques in patients with acute cerebral infarction[J]. Acta Biochim Pol, 2023,70(4):911-917. DOI:10.18388/abp.2020_6817.
[11]Li Y, Zhang M, Lin J, et al. Mitochondrial ATP synthesis and proton transport synergistically mitigate oligodendrocyte progenitor cell dysfunction following transient middle cerebral artery occlusion via the PBX3/DGUOK/KIF21b signaling pathway[J]. Int J Med Sci,2024, 21(11):2189-2200. DOI:10.7150/ijms.100127.
[12]Du W, Fan L, Du J. Neuroinflammation-associated miR-106a-5p serves as a biomarker for the diagnosis and prognosis of acute cerebral infarction[J]. BMC Neurol, 2023, 23(1):248. DOI:10.1186/s12883-023-03241-3.
[13]Xu L, Mi Y, Meng Q, et al. A quinolinyl resveratrol derivative alleviates acute ischemic stroke injury by promoting mitophagy for neuroprotection via targeting CK2α'[J]. Int Immunopharmacol, 2024,137:112524. DOI:10.1016/j.intimp.2024.112524.
[14]Ma C, Cao W, Huang Y, et al. Outcome after endovascular treatment for acute ischemic stroke by underlying etiology:tertiary experience and meta-analysis[J]. Front Neurol, 2023, 14:1065484. DOI:10.3389/fneur.2023.1065484.
[15]Capirossi C, Laiso A, Renieri L, et al. Epidemiology, organization,diagnosis and treatment of acute ischemic stroke[J]. Eur J Radiol Open, 2023, 11:100527. DOI:10.1016/j.ejro.2023.100527.
[16]Yao Y, Liu F, Gu Z, et al. Emerging diagnostic markers and therapeutic targets in post-stroke hemorrhagic transformation and brain edema[J]. Front Mol Neurosci, 2023, 16:1286351. DOI:10.3389/fnmol.2023.1286351.
[17]Liang Z, Lou Y, Hao Y, et al. The relationship of astrocytes and microglia with different stages of ischemic stroke[J]. Curr Neuropharmacol, 2023, 21(12):2465-2480. DOI:10.2174/1570159X21666230718104634.
[18]Li R, Ye JJ, Gan L, et al. Traumatic inflammatory response:pathophysiological role and clinical value of cytokines[J]. Eur J Trauma Emerg Surg, 2024, 50(4):1313-1330. DOI:10.1007/s00068-023-02388-5.
[19]Rambout X, Cho H, Blanc R, et al. PGC-1α senses the CBC of pre-mRNA to dictate the fate of promoter-proximally paused RNAPⅡ[J]. Mol Cell, 2023, 83(2):186-202. DOI:10.1016/j.molcel.2022.12.022.
[20]Abu Shelbayeh O, Arroum T, Morris S, et al. PGC-1α is a master regulator of mitochondrial lifecycle and ROS stress response[J]. Antioxidants(Basel), 2023, 12(5):1075. DOI:10.3390/antiox12051075.
[21]Han W, Zhang E, Tian Y, et al. Adenosine receptor A1 enhanced mitochondrial biogenesis and exerted neuroprotection after cerebral ischemia through PGC-1α[J]. Exp Brain Res, 2023, 241(6):1471-1488. DOI:10.1007/s00221-023-06613-w.
[22]Mohammadi A, Higazy R, Gauda EB. PGC-1α activity and mitochondrial dysfunction in preterm infants[J]. Front Physiol, 2022,13:997619. DOI:10.3389/fphys.2022.997619.
[23]Qin X, Zhang X, He X, et al. Neuron-derived netrin-1 deficiency aggravates spinal cord injury through activating the NF-κB signaling pathway[J]. Heliyon, 2024, 10(17):37388. DOI:10.1016/j.heliyon.2024.e37388.
[24]Wang T, Liu Y, Lu Y, et al. NTN-1 attenuates amyloid-β-mediated microglial neuroinflammation and memory impairment via the NF-κB pathway and NLRP3 inflammasome in a rat model of Alzheimer’s disease[J]. Front Aging Neurosci, 2025, 17:1516399. DOI:10.3389/fnagi.2025.1516399.
[25]Wahl D, Risen SJ, Osburn SC, et al. Nanoligomers targeting NF-κB and NLRP3 reduce neuroinflammation and improve cognitive function with aging and tauopathy[J]. J Neuroinflammation, 2024,21(1):182. DOI:10.1186/s12974-024-03182-9.
[26]徐国栋，董晓莉，梁晓辉，等.血清轴突生长导向因子-1联合HAT评分对急性脑梗死溶栓治疗后出血转化的预测价值[J].疑难病杂志，2025,24(1):18-22. DOI:10.3969/j.issn.1671-6450.2025.01.004.
基本信息:
中图分类号:R743.33
引用信息:
[1]高金堡,宋彦,陈亚伦,等.三种血清指标与老年急性脑梗死患者神经功能缺损程度及预后的关系[J].中华老年心脑血管病杂志,2026,28(05):685-688.
基金信息:
河南省医学科技攻关计划联合共建项目(LHGJ20230962)
2026-05-15
2026-05-15