血清脂联素、超敏C-反应蛋白与急性缺血性脑卒中短期预后的相关性

doi:10.3969/j.issn.1006-9771.2023.10.015

Abstract

Abstract:

Objective To study the association of serum adiponectin and high sensitivity C-reactive protein (hs-CRP) levels to short-term outcome in patients with acute ischemic stroke (AIS).
Methods Clinical data of 216 patients with AIS in Beijing Bo'ai Hospital from January, 2019 to September, 2020 were collected. The serum biochemical indicator was measured in all the patients within 24 hours after enrollment, and adiponectin was detected with enzyme-linked immunosorbent assay. Meanwhile, all patients were evaluated with National Institute of Health Stroke Scale (NIHSS). Modified Rankin Scale (mRS) was used to assess the functional outcome 90 days after onset during follow-up.
Results The incidence of poor outcome in patients with AIS within 90 days was 48.1%. Compared with the good outcome group, the serum adiponectin was lower (t = 5.861, P < 0.001) and the serum hs-CRP level was higher (Z = 5.525, P < 0.001) poor outcome group. Reduced serum adiponectin (OR = 0.862, 95%CI 0.751 to 0.975, P < 0.001) and increased serum hs-CRP (OR = 1.215, 95%CI 1.015 to 1.455, P < 0.001) were independent risk factors for poor outcome in patients with AIS. The areas under curve (95% CI) of serum adiponectin and hs-CRP for predicting the outcome of patients with AIS were 0.819 (0.761 to 0.877) and 0.722 (0.654 to 0.791), respectively (P < 0.001). The predictive power of serum adiponectin was higher than that of hs-CRP (Z = 2.151, P = 0.032). The optimum cut-off point of adiponectin was < 3.5 mg/L, and the Yoden index was 0.609, yielding a sensitivity of 0.704 and a specificity of 0.905.
Conclusion Serum adiponectin and hs-CRP can serve as independent predictors for short functional outcome in patients with AIS.

Key words: acute ischemic stroke, adiponectin, high sensitivity C-reactive protein, short-term outcome, association

CLC Number:

R743.3

ZHANG Chunlong, LIU Fuliang, SHANG Na, LI Fang, LIU Huizhen. Association of serum adiponectin and high sensitivity C-reactive protein levels to short-term outcome in patients with acute ischemic stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(10): 1221-1226.

Figures/Tables 5

References 28

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变量	预后良好 (n = 112)	预后不良 (n = 104)	Z/χ²/t值	P值
年龄/岁	65.0 (58.0, 76.5)	80.0 (65.0, 85.0)	4.594	< 0.001
性别(女)/n	32	49	7.912	0.005
BMI/(kg·m^-2)	25.03±3.42	24.01±3.92	2.051	0.042
高血压/n	77	82	2.830	0.093
糖尿病/n	42	48	1.662	0.197
房颤/n	14	27	6.354	0.012
梗死体积/cm³	0.67 (0.28, 1.82)	6.87 (1.66, 31.8)	7.771	< 0.001
NIHSS评分	2 (1, 2)	6.5 (4, 12)	10.850	< 0.001
HCY/(μmol·L^-1)	16.6 (11.4, 21.6)	17.6 (14.3, 25.1)	1.990	0.047
尿酸/(μmol·L^-1)	334 (282, 410)	324 (253, 406)	0.707	0.480
hs-CRP/(mg·L^-1)	2.30 (1.10, 4.30)	9.70 (2.10, 36.70)	5.525	< 0.001
脂联素/(mg·L^-1)	8.68±1.51	4.20±0.92	5.861	< 0.001

影响因素	B	S.E.	Wald值	df	P值	Exp(B)	95% CI
年龄	0.024	0.019	1.572	1	0.210	1.024	0.986~1.064
性别
男性(参照)	0.000					1.000
女性	-0.117	0.496	0.056	1	0.813	0.889	0.337~2.348
BMI	0.044	0.071	0.388	1	0.533	1.045	0.909~1.202
房颤
无(参照)	0.000					1.000
有	-0.197	0.603	0.106	1	0.744	0.821	0.252~2.680
梗死体积	0.049	0.014	11.335	1	0.001	1.050	1.612~2.607
NIHSS评分	0.718	0.123	34.252	1	< 0.001	2.050	1.819~3.237
hs-CRP	0.195	0.092	4.499	1	0.034	1.215	1.015~1.455
脂联素	-0.148	0.057	13.213	1	< 0.001	0.862	0.751~0.975
常数	-4.304	2.488	2.993	1	0.084	0.014

变量	AUC (95% CI)	分界点	YI	敏感性	特异性	Z值	P值
脂联素	0.819(0.761~0.877)	< 3.5 mg/L	0.609	0.704	0.905	10.154	< 0.001
hs-CRP	0.722(0.654~0.791)	> 9.0 mg/L	0.411	0.566	0.845	6.189	< 0.001
联合变量	0.847(0.792~0.902)	0.394	0.614	0.854	0.760	12.313	< 0.001

对比组1	对比组2	差值	Z值	P值
脂联素	hs-CRP	0.097	2.151	0.032
联合变量	脂联素	0.028	2.040	0.041
联合变量	hs-CRP	0.125	3.214	0.001

Association of serum adiponectin and high sensitivity C-reactive protein levels to short-term outcome in patients with acute ischemic stroke

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