急性脑梗死患者血清泛素羧基末端水解酶-Ⅰ和胶质纤维酸性蛋白的表达及其临床意义

摘要

目的:观察急性脑梗死患者血清泛素羧基末端水解酶-1 (ubiquitin C-terminal hydrolase-LI,UCH-L1)和血清胶质纤维酸性蛋白(serum glial fibrillary acidic protein,GFAP)的临床表达水平,并探讨二者对脑梗死患者的临床意义.方法:选取重庆市肿瘤医院在2014年1月至2016年2月期间收治的80例急性脑梗死患者作为观察组,另选取同时段来院做体格检查的80例健康者作为对照组.分别检测两组研究对象的血清UCH-L1和GFAP的表达水平.结果:UCH-L1诊断脑梗死的敏感度为75.0％,特异度为87.5％;GFAP诊断脑梗死的敏感度为81.3％,特异度为90.0％.UCH-L1和GFAP的受试者工作特征(receiver operating characteristic,ROC)曲线下面积分别为0.670及0.757.两组研究对象在年龄、性别、饮酒、吸烟、糖尿病、高脂血症等一般情况中比较,差异无统计学意义(P＞0.05);观察组患者患高血压的比例明显高于对照组(P＜0.05);经Spearson/Pearson分析显示血清UCH-L1与GFAP水平与高血压呈正比,与性别、年龄、糖尿病、高血脂、饮酒、吸烟等因素无相关性;观察组患者不同发病时间一般资料的比较,差异无统计学意义(P＞0.05),血清UCH-L1和GFAP表达水平明显高于对照组(P＜0.05);在不同发病时间两组患者血清UCH-L1和GFAP表达水平差异无统计学意义(P＞0.05);轻、中、重型3组患者的血清UCH-L1和GFAP表达水平高于对照组(P＜0.05);中、重型患者血清UCH-L1和GFAP表达水平高于轻型(P＜0.05);观察组患者在不同发病时间里血清UCH-L1和GFAP表达水平与梗死灶大小差异有统计学意义(P＜0.05);Pearson相关性分析结果示血清UCH-L1和GFAP表达水平呈正相关(r=0.634,P=0.001).结论:在急性脑梗死患者中早期血清UCH-L1和GFAP的表达水平明显升高,与脑梗死的病情严重程度有一定的相关性,可为临床上早期诊断及治疗提供依据.%Objective:To determine expression levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) and serum glial fibrillary acidic protein (GFAP) in patients with acute cerebral infarction and their clinical significance.Methods:A total of 80 patients with acute cerebral infarction in Chongqing Cancer Hospital from January 2014 to February 2016 were enrolled as an observation group.Another 80 healthy people served as a control group.The expression levels of UCH-L1 and GFAP in the 2 groups were detected.Results:Sensibility and specificity for UCH-L1 and GFAP were 75.0％,87.5％ and 81.3％,90.0％,respectively.Receiver operating characteristic curve areas of UCH-L1 and GFAP were 0.670 and 0.757,respectively.There were no significant significance in age,gender,drinking,smoke,diabetes,and hyperlipidemia in the 2 groups (P＞0.05).High blood pressure rate in the observation group was higher than that in the control group (P＜0.05).Spearson/Pearson analysis showed that serum UCH-L1 and GFAP levels were positively correlated with hypertension,but they were negatively correlated with sex,age,diabetes,hyperlipidemia,alcohol consumption,smoking,and other factors.General data at different time in the observation group was not statistically different (P＞0.05).The expression levels of UCH-L1 and GFAP in the observation group was higher than that in the control group (P＜0.05).UCH-L1 and GFAP levels at different time in the 2 groups were not statistically different (P＞0.05).UCH-L1 and GFAP levels in the light,medium,and heavy groups were higher than those in the control group (P＜0.05),while UCH-L1 and GFAP levels in the medium and heavy groups were higher than those in the light group (P＜0.05).There was significant difference between levels of UCH-L1 or GFAP and infarction size at different time in the observation group (P＜0.05).The results of Pearson correlation analysis showed that the levels of serum UCH-L1 and GFAP were positively correlated (r=0.634,P=0.001).Conclusion:The levels of serum UCH-L1 and GFAP are significantly increased at the early stage of acute cerebral infarction,and they have a certain correlation with the severity of cerebral infarction,which can provide a basis for early clinical diagnosis and treatment.