作者：郑娟，孔敏，宋晓宇，田升军，李燕，于天霞

单位：

264000山东省烟台市烟台山医院神经内科

Units：

Department of Neurology, Yantai Yantaishan Hospital, Yantai 264000, China

关键词：

再灌注损伤；脑缺血再灌注损伤；白蛋白/纤维蛋白原比值；核因子E2相关因子2；血红素氧合酶 1；诊断

Keywords：

Reperfusion injury; Cerebral ischemia reperfusion injury; Albumin to fibrinogen ratio; Nuclear factor erythroid-2 related factor 2; Hemeoxygenase 1; Diagnosis

CLC：

R 619.9

DOI：

10.12114/j.issn.1008-5971.2024.00.022

Funds：

山东省重点研发计划项目（2018GSF118235）

摘要：

目的　分析白蛋白/纤维蛋白原比值（AFR）、核因子E2相关因子2（Nrf2）、血红素氧合酶1 （HO-1）对脑缺血再灌注损伤（CIRI）的诊断价值。方法　选取2020年1月—2023年6月烟台市烟台山医院收治的 CIRI患者105例为观察组，另选取同期于烟台市烟台山医院体检者105例为对照组。收集研究对象一般资料、AFR、 Nrf2、HO-1。采用多因素Logistic回归分析探讨CIRI的影响因素；采用受试者工作特征（ROC）曲线分析AFR、 Nrf2、HO-1及三者联合对CIRI的诊断价值。结果　观察组AFR、Nrf2、HO-1低于对照组（P＜0.05）。多因素Logistic 回归分析结果显示，AFR、Nrf2、HO-1是CIRI的影响因素（P＜0.05）。ROC曲线分析结果显示，AFR、Nrf2、 HO-1诊断CIRI的AUC分别为0.854〔95%CI（0.794～0.915）〕、0.815〔95%CI（0.756～0.873）〕、0.831〔95%CI （0.775～0.888）〕，最佳截断值分别为9.7、3.2 μg/L、168.5 nmol/L，灵敏度分别为98.10%、89.50%、85.70%， 特异度分别为75.20%、64.80%、71.40%；三者联合诊断CIRI的AUC为0.926〔95%CI（0.883～0.968）〕，灵敏度为 95.20%，特异度为87.60%。结论　AFR、Nrf2、HO-1是CIRI的影响因素，且其均对CIRI具有中等诊断价值，而三者联 合的诊断价值更高。

Abstract：

Objective To investigate the diagnostic value of albumin to fibrinogen ratio (AFR) , nuclear factor erythroid-2 related factor 2 (Nrf2) and heme oxygenase-1 (HO-A) for cerebral ischemia-reperfusion injury (CIRI) . Methods A total of 105 CIRI patients admitted to Yantai Yantaishan Hospital from January 2020 to June 2023 were selected as the observation group, and 105 physical examination people who underwent physical examination in Yantai Yantaishan Hospital during the same period were selected as the control group. General information, AFR, Nrf2 and HO-1 of the subjects were collected. Multivariate Logistic regression analysis was used to explore the influencing factors of CIRI. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of AFR, Nrf2, HO-1 and their combination for CIRI. Results AFR, Nrf2 and HO-1 in observation group were lower than those in control group (P < 0.05) . The results of multivariate Logistic regression analysis showed that AFR, Nrf2 and HO-1 were the influencing factors of CIRI (P < 0.05) . ROC curve analysis results showed that the AUC of AFR, Nrf2, and HO-1 in diagnosing CIRI was 0.854 [95%CI (0.794-0.915) ] , 0.815 [95%CI (0.756-0.873) ] , 0.831 [95%CI (0.775-0.888) ] , the optimal cut-off values were 9.7, 3.2 μg/L and 168.5 nmol/L, the sensitivity was 98.10%, 89.50% and 85.70%, and the specificity was 75.20%, 64.80% and 71.40%, respectively; the AUC of their combination in diagnosing CIRI was 0.926 [95%CI (0.883-0.968) ] , the sensitivity was 95.20%, and the specificity was 87.60%. Conclusion AFR, Nrf2 and HO-1 are influencing factors of CIRI, and they all have medium diagnostic value for CIRI, and the combined diagnostic value is higher.

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