|
| FNDC5 P2X7R与急性脑梗死患者脑梗死体积及神经功能的相关性分析 |
| Correlation of FNDC5 and P2X7R with cerebral infarction volume and neurological function |
| 投稿时间：2025-06-30 |
| DOI：10.3969/j.issn.1000-0399.2026.05.016 |
| 中文关键词: 急性脑梗死 纤维连接蛋白Ⅲ型域包含蛋白5 P2X嘌呤受体7 病灶体积 神经功能缺损 |
| 英文关键词: Acute cerebral infarction Fibronectin type Ⅲ domain-containing protein 5 Purinergic 2X7 receptor Lesion volume Neurological deficits |
| 基金项目: |
|
| 摘要点击次数: 256 |
| 全文下载次数: 105 |
| 中文摘要: |
| 目的 探讨急性脑梗死患者血清纤维连接蛋白Ⅲ型域包含蛋白5（FNDC5）、P2X嘌呤受体7（P2X7R）水平与病灶体积、神经功能缺损程度的关系。方法 选取2022年11月至2024年11月于西安大兴医院就诊的急性脑梗死患者100例，根据病灶体积分为小梗死组（n=42）、中梗死组（n=35）、大梗死组（n=23）。根据美国国立卫生研究院卒中量表（NIHSS）评分确定神经功能缺损严重程度，并将患者分为轻度组（n=47）和中重度组（n=53）。测定纳入对象血清FNDC5、P2X7R水平；采用Pearson分析FNDC5、P2X7R与NIHSS评分的相关性；利用logistic回归分析影响神经功能缺损程度的因素；采用Kappa检验分析血清FNDC5、P2X7R水平对患者神经功能缺损程度的交互作用；受试者工作特征（ROC）曲线评估血清FNDC5、P2X7R对急性脑梗死患者神经功能缺损程度的临床价值。结果 与小梗死组相比，中、大梗死组FNDC5水平降低，P2X7R水平升高（P<0.05）；大梗死组FNDC5水平低于中梗死组，P2X7R水平高于中梗死组（P<0.05）；与轻度组比较，中重度组三酰甘油、病灶体积、NIHSS评分和P2X7R均升高，FNDC5水平降低（P<0.05）；血清FNDC5、P2X7R水平与NIHSS评分具有相关性（r=-0.499、0.599,P<0.05）；交互作用分析显示，FNDC5低表达且P2X7R高表达时，中重度神经功能缺损发生风险增加（OR=11.429,95%CI:3.302～39.550），协同效应指数（SI）为1.826；病灶体积、NIHSS评分和P2X7R升高是中重度神经功能缺损发生的危险因素，FNDC5为保护因素（P<0.05）；血清FNDC5、P2X7R区分轻度和中重度神经功能缺损的联合评估价值较高（AUC=0.916,95%CI:0.844～0.962），高于两指标单独预测(Z二者联合-FNDC5=2.740、P=0.006,Z二者联合-P2X7R=2.762、P=0.006)。结论 急性脑梗死患者FNDC5、P2X7R水平与脑梗死体积、NIHSS评分相关，且二者在预测患者神经功能缺损程度上具有一定临床价值。 |
| 英文摘要: |
| Objective To investigate the relationship between the serum fibronectin type Ⅲ domain-containing protein 5（FNDC5） and purinergic 2X7 receptor（P2X7R） levels with lesion volume and the degree of neurological deficits in patients with acute cerebral infarction. Methods From November 2022 to November 2024, 100 patients with acute cerebral infarction in our hospital were gathered and divided into the small infarction group（42 cases）, medium infarction group（35 cases）, and large infarction group（23 cases） based on lesion volume. The severity of neurological deficits was determined based on the National Institutes of Health Stroke Scale（NIHSS） score, and patients were assigned into a mild group（47 cases） and a moderate to severe group（53 cases）. The levels of serum FNDC5 and P2X7R were measured. Pearson method was used to analyze the correlation between FNDC5 and P2X7R with NIHSS scores. Kappa test was used to analyse the interaction between serum FNDC5 and P2X7R levels and the degree of neurological dysfunction in patients. Logistic regression was used to analyze factors that affected the degree of neurological deficits. The receiver operating characteristic（ROC） curve was used to assess the clinical value of serum FNDC5 and P2X7R in assessing the degree of neurological deficit in patients with acute cerebral infarction. Results Compared with the small infarction group, the FNDC5 decreased and the P2X7R increased in the medium and large infarction groups（P<0.05）. The FNDC5 in the large infarction group was lower than that in the medium infarction group, and the P2X7R was higher than that in the medium infarction group（P<0.05）. Compared with the mild group, the moderate to severe group showed prominent increases in triglycerides, lesion volume, NIHSS score, and P2X7R, and prominent decrease in FNDC5（P<0.05）. Serum FNDC5 and P2X7R were prominently correlated with NIHSS score（r=-0.499, 0.599, P<0.05）. Interaction analysis showed that when FNDC5 was lowly expressed and P2X7R was highly expressed, the risk of moderate to severe neurological deficits increased significantly（OR=11.429）, with a synergy index（SI） of 1.826. The increases in lesion volume, NIHSS score, and P2X7R were risk factors for the occurrence of moderate to severe neurological deficits, while FNDC5 was a protective factor（P<0.05）. The combined assessment value of serum FNDC5 and P2X7R in distinguishing mild and moderate to severe neurological deficits was relatively high（AUC=0.916）, which was prominently higher than the individual predictions of the two indicators(Zcombination-FNDC5=2.740, P=0.006, Zcombination-P2X7R=2.762, P=0.006). Conclusion The levels of FNDC5 and P2X7R in patients with acute cerebral infarction are prominently correlated with cerebral infarction volume and NIHSS score, and both have certain clinical value in predicting the degree of neurological deficits in patients. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
