| 王程晓,任毅,刘娟娟,等.血清泛素羧基末端水解酶 L1、组织金属蛋白酶抑制物 -2联合检测对急性大血管闭塞性缺血性卒中病人机械取栓后出血转化及短期预后的预测价值[J].安徽医药,2026,30(6):1172-1176. |
| 血清泛素羧基末端水解酶 L1、组织金属蛋白酶抑制物 -2联合检测对急性大血管闭塞性缺血性卒中病人机械取栓后出血转化及短期预后的预测价值 |
| Value of combined serum ubiquitin C-terminal hydrolase-L1 and tissue inhibitor of metalloproteinase-2 in predicting hemorrhagic transformation and short-term prognosis aftermechanicalthrombectomyinpatientswithacuteischemicstroke withlargevesselocclusion |
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| DOI：10.3969/j.issn.1009-6469.2026.06.022 |
| 中文关键词: 脑梗死 卒中 泛素羧基末端水解酶 L1 组织金属蛋白酶抑制物 -2 机械取栓 出血转化 预后 |
| 英文关键词: Brain infarction Stroke Ubiquitin C-terminal hydrolase-L1 Tissue inhibitor of metalloproteinase-2 Mechanical thrombectomy Hemorrhagic transformation Prognosis |
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| 中文摘要: |
| 目的分析急性大血管闭塞性缺血性卒中(AIS-LVO)病人血清泛素羧基末端水解酶 L1(UCH-L1)、组织金属蛋白酶抑制物-2(TIMP-2)预测机械取栓后出血转化(HT)及短期预后的价值。方法回顾性研究。将 2019年 4月至 2022年 10月沧州市人民医院收治的 132例 AIS-LVO病人作为研究对象，根据是否发生 HT分为 HT组 39例，非 HT组 93例。根据 3个月随访后改良 Rankin量表(mRS)评分分为不良组 26例，良好组 106例。采用多因素 logistic回归分析探索病人预后不良影响因素。采用受试者操作特征曲线(ROC曲线)分析血清 UCH-L1、TIMP-2水平对 AIS-LVO病人机械取栓后 HT及短期预后的诊断价值。结果 HT组病人血清 UCH-L1［(4.26±0.55)μg/L比( 3.54±0.43)μg/L］TIMP-2［(48.75±6.37)μg/L比(40.16±5.58)μg/L］水平显著高于非 HT组，不良组病人血清 UCH-L1［(4.42±0.53)μg/L比( 3.59±0.45)μ、g/L］、 TIMP-2［(49.53±6.52)μg/L比(41.02±5.64)μg/L］水平显著高于良好组( P<0.05)。不良组美国国立卫生研究院卒中量表( NIHSS)、 mRS评分高于良好组( P<0.05)。血清 UCH-L1、TIMP-2联合诊断 AIS-LVO病人机械取栓后 HT发生的 AUC为 0.94，优于各自单独诊断(Z=2.18，P=0.030；Z=2.26，P=0.024)与金标准间具有较好一致性( Kappa=0.83，P<0.001)。UCH-L1、TIMP-2联合诊断病人预后的 AUC为 0.95，显著优于各自单独诊断，(Z=2.04，P=0.041；Z=2.68，P=0.007)，与金标准间具有一致性( Kappa=0.64，P<0.001)。多因素 logistic回归分析表明， UCH-L1、TIMP-2是 AIS-LVO病人机械取栓后 HT发生及预后不良的危险因素( P<0.05)。结论 AIS-LVO病人血清 UCH-L1、TIMP-2水平与机械取栓后 HT发生及预后关系密切，可作为预测 AIS-LVO病人机械取栓后 HT和预后评估的重要指标。 |
| 英文摘要: |
| Objective To evaluate the value of serum ubiquitin C-terminal hydrolase-L1 (UCH-L1) and tissue inhibitor of metallopro. teinase-2 (TIMP-2) levels in predicting hemorrhagic transformation (HT) after mechanical thrombectomy in patients with acute isch.emic stroke with large vessel occlusion (AIS-LVO) and their relationship with short-term prognosis.Methods A retrospective study. A total of 132 AIS-LVO patients admitted to Cangzhou People's Hospital between April 2019 and October 2022 were included in thestudy. Based on the occurrence of HT, the patients were divided into an HT group (39 cases) and a non-HT group (93 cases). Based on modified Rankin scale (mRS) scores at the 3-month follow-up, patients were classified into an unfavorable group (n=26) and a favorable group (n=106). Multivariate logistic regression analysis was performed to identify factors associated with poor patient prognosis. ROCcurve analysis was used to evaluate the diagnostic value of serum UCH-L1 and TIMP-2 levels for predicting post-mechanical thrombec. tomy HT and short-term prognosis in AIS-LVO patients.Results Serum UCH-L1 [(4.26±0.55) μg/L vs. (3.54±0.43) μg/L] and TIMP-2 [(48.75±6.37) μg/L vs. (40.16±5.58) μg/L] levels in the HT group were significantly higher than those in the non-HT group. In the unfa. vorable group, serum UCH-L1 [(4.42±0.53) μg/L vs. (3.59±0.45) μg/L] and TIMP-2 [(49.53±6.52) μg/L vs. (41.02±5.64) μg/L] were sig. nificantly higher than those in the favorable group (P<0.05). The NIHSS and mRS scores in the unfavorable group were higher than those in the favorable group (P<0.05). The AUC for the combined use of serum UCH-L1 and TIMP-2 had an AUC of 0.94 for predicting the occurrence of HT in AIS-LVO patients after mechanical thrombectomy, outperforming individual diagnostics (Z=2.18, P=0.030; Z= 2.26, P=0.024) and demonstrating good agreement with the gold standard (Kappa=0.83, P<0.001). The AUC for the combined UCH-L1 and TIMP-2 prediction of patient prognosis was 0.95, significantly superior to individual predictions (Z=2.04, P=0.041; Z=2.68, P= 0.007), and showed agreement with the gold standard (Kappa=0.64, P<0.001). Multivariate logistic regression analysis indicated that UCH-L1 and TIMP-2 were risk factors for HT occurrence and poor prognosis in AIS-LVO patients following mechanical thrombectomy (P<0.05).Conclusion The serum levels of UCH-L1 and TIMP-2 in AIS-LVO patients are closely associated with the occurrence andprognosis of hemorrhagic stroke following mechanical thrombectomy, and can serve as important indicators for predicting hemorrhagicstroke and assessing prognosis in these patients. |
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