急性脑梗死患者血浆高迁移率族蛋白B1/Toll样受体4变化及其与脑梗死体积、神经功能缺损及预后的关系

Changes in plasma high-mobility group box 1/Toll-like receptor 4 and their correlation with cerebral infarction volume, neurological deficits, and prognosis in patients with acute cerebral infarction

摘要:

目的 观察急性脑梗死(ACI)患者血浆高迁移率族蛋白B1(HMGB1)/Toll样受体4(TLR4)变化及其与脑梗死体积、神经功能缺损及预后的关系。方法 选取2018年1月至2020年7月该院收治的186例ACI患者（研究组）和45例健康人员（对照组）。研究组患者依据脑梗死体积、美国国立卫生研究院卒中量表(NIHSS)评分及预后情况进行分组。对比各组血浆HMGB1、TLR4水平；Pearson相关性分析其与脑梗死体积、神经功能缺损间的相关性；受试者工作特征(ROC)曲线评估其在预后预测中的价值。结果 研究组血浆HMGB1、TLR4水平明显高于对照组，差异有统计学意义(P<0.05)。大、中、小梗死组血浆HMGB1、TLR4水平依次递减，差异有统计学意义(P<0.05)。重、中、轻度损伤组血浆HMGB1、TLR4水平依次递减，差异有统计学意义(P<0.05)。预后良好组血浆HMGB1、TLR4水平明显低于预后不良组(P<0.05)。ACI患者的血浆HMGB1、TLR4水平与脑梗死体积、NIHSS评分均呈正相关(P<0.05)。ROC结果显示，HMGB1、TLR4用于ACI患者预后的AUC值分别为0.892、0.870。结论 ACI患者血浆HMGB1、TLR4水平与脑梗死体积、神经功能缺损相关；可用于预测ACI患者的预后。

Abstract:

Objective To investigate the changes in plasma high-mobility group box1 （HMGB1）/Toll-like receptor 4 （TLR4） and their correlation with cerebral infarction volume， neurological deficits， and prognosis in patients with acute cerebral infarction （ACI）.Methods A total of 186 patients with ACI who were admitted to our hospital from January 2018 to July 2020 were enrolled as study group， and 45 healthy individuals were enrolled as control group. The patients in the study group were further divided into groups according to cerebral infarction volume， National Institutes of Health Stroke Scale （NIHSS） score， and prognosis. The plasma levels of HMGB1 and TLR4 were compared between groups， and the Pearson correlation analysis was used to investigate their correlation with cerebral infarct volume and neurological deficits； the receiver operating characteristic （ROC） curve was used to investigate their value in predicting prognosis.Results The study group had significantly higher plasma levels of HMGB1 and TLR4 than the control group （P<0.05）. The large infarction group had the highest plasma levels of HMGB1 and TLR4， followed by the medium infarction group and the small infarction group （P<0.05）. The severe injury group hand the highest plasma levels of HMGB1 and TLR4， followed by the moderate injury group and the mild injury group （P<0.05）. The good prognosis group had significantly lower plasma levels of HMGB1 and TLR4 than the poor prognosis group （P<0.05）. The plasma levels of HMGB1 and TLR4 were positively correlated with cerebral infarction volume and NIHSS score in ACI patients （P<0.05）. The ROC curve analysis showed that HMGB1 and TLR4 had an area under the ROC curve of 0.892 and 0.870， respectively， in predicting the prognosis of ACI patients.Conclusions The plasma levels of HMGB1 and TLR4 are correlated with cerebral infarction volume and neurological deficits in ACI patients and can thus be used to predict the prognosis of ACI patients.