急性脑梗死合并脑白质疏松症患者血清CP、MBP、MCP-1与病情严重程度和预后的关系

摘要 目的：探究急性脑梗死（ACI）合并脑白质疏松症（LA）患者血清C肽（CP）、髓鞘碱性蛋白（MBP）、单核细胞趋化蛋白-1（MCP-1）水平与病情严重程度和预后关系。方法：选取南京鼓楼医院集团宿迁医院于2021年3月至2023年3月期间收治的ACI合并LA患者117例作为观察组，根据根据LA严重程度分为重度组39例、中度组40例和轻度组38例。另选取同期体检健康人120例纳入对照组。检测血清CP、MBP、MCP-1水平。对ACI合并LA患者行6个月的随访。多因素Logistic回归分析ACI合并LA患者预后不良的影响因素。受试者特征曲线（ROC）分析血清CP、MBP和MCP-1对ACI合并LA患者预后的预测价值。结果：与对照组相比，观察组MBP、MCP-1更高，CP更低（P<0.05）。重度组血清CP显著低于轻度组和中度组，MBP、MCP-1水平显著高于轻度组和中度组；中度组血清CP显著低于轻度组，MBP、MCP-1水平显著高于轻度组（均P<0.05）。与预后良好组相比，预后不良组CP更低，MBP、MCP-1更高（P<0.05）。多因素Logistic回归分析显示NIHSS评分升高、MBP升高、MCP-1升高是ACI合并LA患者预后不良的独立危险因素，CP升高是保护因素（P<0.05）。ROC分析结果显示CP、MBP和MCP-1联合预测ACI合并LA患者预后不良的曲线下面积（AUC）为0.916，高于CP、MBP和MCP-1单独预测。结论：ACI合并LA患者血清CP较健康群体更低，血清MBP、MCP-1水平较健康群体更高，且CP、MBP和MCP-1与患者病情程度存在密切联系。血清CP、MBP和MCP-1联合检测对ACI合并LA患者预后有较高预测价值。

Relationship between Serum CP, MBP, and MCP-1 and Disease Severity and Prognosis in Patients with Acute Cerebral Infarction Combine with Leukoaraiosis

ABSTRACT Objective: To explore the relationship between serum C peptide (CP), myelin basic protein (MBP), monocyte chemotactic protein-1 (MCP-1) levels and disease severity and prognosis in patients with acute cerebral infarction (ACI) combine with leukoaraiosis (LA). Methods: 117 patients with ACI combine with LA admitted to Suqian Hospital of Nanjing Gulou Hospital Group from March 2021 to March 2023 were selected as observation group, patients were divided into severe group (39 cases), moderate group (40 cases), and mild group (38 cases) according to the severity of LA. 120 healthy individuals who underwent physical examinations during the same period were selected as control group. Detected serum levels of CP, MBP, and MCP-1. Follow up patients with ACI combine with LA 6 months. The influencing factors of poor prognosis in patients with ACI combined with LA were analyzed by multivariate Logistic regression. The predictive value of serum CP, MBP and MCP-1 in ACI patients with LA was analyzed by receiver operating characteristic(ROC) curve. Results: Compared with control group, observation group had higher levels of MBP and MCP-1, lower levels of CP (P<0.05). Serum CP in severe group was lower than that in mild and moderate groups, and the levels of MBP and MCP-1 were higher than those in mild and moderate groups; Serum CP in moderate group was lower than that in mild group, and the levels of MBP and MCP-1 were higher than those in mild group (all P<0.05). Compared with good prognosis group, poor prognosis group had lower CP and higher MBP and MCP-1 (P<0.05). Multivariate logistic regression analysis showed that elevated NIHSS score, MBP, and MCP-1 were independent risk factors for poor prognosis in patients with ACI combine with LA, and elevated CP was a protective factor (P<0.05). ROC analysis results showed that the area under the curve (AUC) of CP, MBP, and MCP-1 combined predicting poor prognosis in patients with ACI combine with LA was 0.916, significantly higher than CP, MBP and MCP-1 alone. Conclusion: The serum CP of patients with ACI combine with LA is lower than that in healthy group, and the serum MBP and MCP-1 levels are higher than those in healthy group, and there is a close relationship between CP, MBP, and MCP-1 and the severity of the patient''s condition. The combined detection of serum CP, MBP, and MCP-1 has high predictive value for the prognosis of patients with ACI combine with LA.