血清固醇调节元件结合蛋白2与急性脑梗死相关性研究

Correlation between serum sterol regulatory element binding protein-2 and acute cerebral infarction

摘要:

目的 探讨血清固醇调节元件结合蛋白2（sterol regulatory element binding protein-2，SREBP-2）与急性脑梗死的相关性。方法 纳入2020年10月至2021年3月入住的134名急性脑梗死患者和34名健康体检者。通过酶联免疫吸附实验法（enzyme-linked immunosorbent assay，ELISA）检测血清SERBP-2浓度，并依据急性卒中Org 10 172治疗试验（trial of Org 10 172 in acute stroke treatment，TOAST）分型和是否合并糖尿病进行亚组分析。使用美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分评估患者的病情严重程度，并分析血清SREBP-2与病情严重程度的相关性。使用改良Rankin量表评估患者的90 d功能预后，并将患者分为预后良好组和预后不良组，比较2组的血清SREBP-2浓度差异，并通过logistic回归分析血清SREBP-2是否与脑梗死预后相关。结果 脑梗死组的血清SREBP-2浓度明显低于对照组［72.60（57.50，83.35） ng/mL vs. 86.80（77.20，97.90） ng/mL，P=0.000］。血清SREBP-2浓度识别急性脑梗死患者和健康人群的曲线下面积为0.782（P=0.000）。大动脉粥样硬化型、心源性栓塞型、小动脉闭塞型脑梗死血清SREBP-2浓度均明显低于对照组（P=0.000，P=0.003，P=0.000）。合并糖尿病患者的血清SREBP-2高于不合并糖尿病的患者（P=0.021）。血清SREBP-2浓度与入院NIHSS评分无相关性（P>0.05）。脑梗死患者预后良好组血清SREBP-2浓度较预后不良组低，但差异无统计学意义（P>0.05），logistic回归分析显示血清SREBP-2浓度与脑梗死90 d功能预后无关（OR=1.016，95%CI=0.991~1.042，P=0.205）。结论 血清SREBP-2浓度在急性脑梗死患者中明显下降。血清SREBP-2对识别脑梗死患者与健康人群具有一定的效能。然而，血清SREBP-2浓度与患者病情严重程度和预后无关。

Abstract:

Objective To explore the correlation between serum sterol regulatory element binding protein-2（SREBP-2） and acute cerebral infarction（ACI）.Methods From October 2020 to March 2021，134 ACI patients were recruited as the ACI group and 34 healthy individuals were recruited as the control group. Serum SERBP-2 concentration was detected by enzyme-linked immunosorbent assay（ELISA） and subgroup analysis was conducted based on trial of Org 10 172 in acute stroke treatment（TOAST） classification and whether patients had diabetes mellitus. National Institutes of Health Stroke Scale（NIHSS） score was used to evaluate the disease severity of patients and the correlation between serum SREBP-2 and the severity was analyzed. The modified Rankin scale was used to assess the 90-day functional prognosis of the ACI group. The ACI patients were classified into favorable outcomes group and unfavorable outcomes group and serum SREBP-2 concentration of two groups were compared. Logistic regression was used to analyze whether serum SREBP-2 was related to ACI prognosis.Results Serum SREBP-2 concentration of the ACI group was significantly lower than that of the control group［72.60 （57.50， 83.35） ng/mL vs. 86.80（77.20，97.90） ng/mL，P=0.000］. The area under the curve for serum SREBP-2 concentration to identify patients with ACI and healthy people was 0.782（P=0.000）. Serum SREBP-2 concentrations of subtype of large artery atherosclerosis，cardio-embolism and small artery occlusion were all lower than that of the control group（P=0.000，P=0.003，P=0.000）. Serum SREBP-2 concentration of ACI patients with diabetes mellitus was higher than those without（P=0.021）. In the ACI group，serum SREBP-2 concentration was not correlated with the NIHSS score at admission（P>0.05）. Serum SREBP-2 concentration of the favorable outcomes group was lower than that of the unfavorable outcomes group，but the difference had no statistical significance（P>0.05）. Logistic regression analysis showed that serum SREBP-2 concentration was not associated with 90-day functional prognosis of ACI（OR=1.016，95%CI=0.991-1.042，P=0.205）.Conclusion Serum SREBP-2 concentration decreases significantly in ACI patients. Serum SREBP-2 has a certain efficacy in identifying patients with ACI and healthy people. However，serum SREBP-2 has no correlation with the severity and prognosis of ACI patients.