急性脑梗死患者同型半胱氨酸血小板相关参数与急诊介入溶栓后临床结局的关系

doi:10.3969/j.issn.1006-6233.2025.06.07

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摘要 目的: 观察急性脑梗死(ACI)患者血清同型半胱氨酸(Hcy)、血小板相关参数变化与急诊介入溶栓后临床结局的关系。方法: 纳入2022年8月至2024年6月本院收治的116例ACI患者,所有入组患者接受急诊介入溶栓治疗,并通过观察介入前患者血清Hcy及血小板相关参数[血小板计数(PLT)、膜糖蛋白p-选择素(P-selection,CD62P)、PLT分布宽度(PDW)]变化,分析其与患者临床结局的关系。结果: 预后不良患者Hcy、CD62P、PDW水平高于预后良好患者,差异有统计学意义(P<0.05),预后不良患者PLT水平低于预后良好患者,差异有统计学意义(P<0.05);Spearman相关性分析显示:Hcy、CD62P、PDW水平与改良Rankin量表(mRS)评分成正相关(r=4.766、3.862、4.268,P<0.05),PLT水平与mRS评分成负相关(r=-3.984,P<0.05);单因素分析显示:合并糖尿病、年龄、发病至入院时间、美国国立卫生研究院卒中量表(NIHSS)评分与ACI患者临床结局有关,差异有统计学意义(P<0.05);Logistic回归分析显示:合并糖尿病、年龄、发病至入院时间、NOHSS评分及Hcy、CD62P、PDW水平是影响患者临床结局的危险因素(P<0.05),PLT水平是影响患者临床结局的保护因素(P<0.05);ROC曲线显示:Hcy、PLT、CD62P、PDW评估ACI患者出院90d预后不良的AUC分别为0.816、0.744、0.732、0.804。结论: Hcy、PLT、CD62P、PDW水平异常与急诊介入溶栓ACI患者临床结局存在一定的关系,并对其具有一定的评估价值。

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关键词 ：急性脑梗死, 介入溶栓, 同型半胱氨酸, 预后, 预测价值

Abstract：Objective: To observe the relationship between changes of serum homocysteine (Hcy) and platelet-related parameters and clinical outcomes after emergency interventional thrombolysis in patients with acute cerebral infarction (ACI). Methods: Totally 116 patients with ACI in the hospital were included from August 2022 to June 2024. All enrolled patients received emergency interventional thrombolytic therapy. The changes of serum Hcy and platelet-related parameters [platelet count (PLT), membrane glycoprotein p-selectin (P-selection, CD62P), platelet distribution width (PDW)] were observed before intervention, and the relationship with clinical outcomes of patients was analyzed. Results: The levels of Hcy, CD62P and PDW in patients with poor prognosis were higher than those in patients with good prognosis (P<0.05) while the PLT level was lower than that in patients with good prognosis (P<0.05). Spearman correlation analysis indicated that Hcy, CD62P and PDW were positively correlated with modified Rankin scale (mRS) score (r=4.766, 3.862, 4.268, P<0.05), and PLT level was negatively correlated with mRS score (r=-3.984, P<0.05). Univariate analysis revealed that diabetes mellitus, age, time from onset to admission, and National Institutes of Health Stroke Scale (NIHSS) score were associated with clinical outcomes of ACI patients (P<0.05). Logistic regression analysis found that diabetes mellitus, age, time from onset to admission, NIHSS score, Hcy, CD62P and PDW were risk factors affecting the clinical outcomes of patients (P<0.05), and PLT level was a protective factor (P<0.05). ROC curve demonstrated that the AUCs of Hcy, PLT, CD62P and PDW in evaluating the clinical outcomes were 0.816, 0.744, 0.732 and 0.804 respectively. Conclusion: The abnormal levels of Hcy, PLT, CD62P and PDW are related to clinical outcomes of ACI patients with emergency interventional thrombolysis, and have certain evaluated value.

Key words： Acute cerebral infarction Interventional thrombolysis Homocysteine Prognosis Predictive value

基金资助:陕西省自然科学基础研究计划项目,(编号:2023-JC-QN-0949)

通讯作者: 杨慧玲

引用本文:

张盼, 白洁, 徐银美, 宋莉, 席佩, 杨慧玲. 急性脑梗死患者同型半胱氨酸血小板相关参数与急诊介入溶栓后临床结局的关系[J]. 河北医学, 2025, 31(6): 912-917.
ZHANG Pan, BAI Jie, XU Yinmei, et al. Relationship between Homocysteine Platelet-Related Parameters and Clinical Outcomes in Patients with Acute Cerebral Infarction after Emergency Interventional Thrombolysis. HeBei Med, 2025, 31(6): 912-917.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.06.07 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I6/912

[1] 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.中国重症卒中管理指南2024[J].中华神经科杂志,2024,57(7):698-714.
[2] 王康萌,赵振强,赵博,等.急性脑梗死动脉溶栓治疗的进展与展望[J].重庆医学,2024,53(12):1883-1888.
[3] Ludhiadch A,Yadav P,Singh SK,et al.Evaluation of mean platelet volume and platelet count in ischemic stroke and its subtypes:focus on degree of disability and thrombus formation[J].Int Neurosci,2024,134(5):503-510.
[4] Hermann A,Sitdikova G.Homocysteine:biochemistry,molecular biology and role in disease[J].Biomolecules,2021,11(5):737.
[5] 段庆希,孙雪,主红艳.血清Cys C、MMP-8、CHE水平对急性脑梗死患者预后的预测价值[J].山东医药,2020,60(22):88-90.
[6] 薛涵,高静,王冬静,等.Lp-PLA2 LP(a)ApoB/ApoA-1水平与急性脑梗死严重程度及预后的相关性分析[J].河北医学,2024,30(5):857-863.
[7] Jiang M,Shen J,Muhammad B,et al.Red blood cell distribution width to platelet ratio predicts early neurological deterioration in acute ischemic stroke patients receiving intravenous thrombolysis[J].Stroke Cerebrovasc Dis,2023,32(7):107146.
[8] Ludhiadch A,Sulena,Singh S,et al.Genomic variation affecting MPV and PLT count in association with development of ischemic stroke and its subtypes[J].Mol Neurobiol,2023,60(11):6424-6440.
[9] Izzi B,Gialluisi A,Gianfagna F,et al.Platelet distribution width Is associated with P-selectin dependent platelet function:results from the moli-family cohort study[J].Cells,2021,10(10):2737.
[10] 丁笑笑,朱瑞,随旭.血小板参数联合凝血指标对急性脑梗死早期病情进展的预测价值[J].心血管康复医学杂志,2022,31(2):147-154.
[11] Zhu Z,Li S,Jia Y,et al.Homocysteine promotes migration of adventitial fibroblasts via angiotensin Ⅱ type 1 receptor activation to aggravate atherosclerosis[J].Gen Physiol Biophys,2022,41(6):535-547.
[12] Wyse ATS,Bobermin LD,Dos Santos TM,et al.Homocysteine and gliotoxicity[J].Neurotox Res,2021,39(3):966-974.
[13] Gou Y,Ye Q,Liang X,et al.Homocysteine restrains hippocampal neurogenesis in focal ischemic rat brain by inhibiting DNA methylation[J].Neurochem Int,2021(147):105065.