中国冶金工业医学杂志

GRASPS模型联合血清CTRP3和MMP-9检测对缺血性脑卒中患者溶栓后出血转化的预测价值

作者：赵红玉

关键词：GRASPS模型补体C1q/肿瘤坏死因子相关蛋白3 基质金属蛋白酶-9 缺血性脑卒中

分类号：R 743.3

出版年,卷(期):页码：2024,41(4):377-379

摘要：

摘要：目的探讨GRASPS模型联合血清补体C1q/肿瘤坏死因子相关蛋白3（CTRP3）、基质金属蛋白酶-9（MMP-9）检测对缺血性脑卒中患者溶栓后出血转化的预测价值。方法选取2020年1月—2022年1月在我院就诊的135例急性缺血性脑卒中患者，其中，发生出血转化28例、未发生出血转化107例。比较患者的临床资料、GRASPS模型评分、血清CTRP3、MMP-9等差异。结果出血转化患者的心房纤颤率高于非出血转化患者，比较差异有统计学意义（χ2＝37.703，P＜0.05）；出血转化患者入院时的收缩压和舒张压、GRASPS模型评分、MMP-9均高于非出血转化患者，而CTRP3低于非出血转化患者，比较差异均有统计学意义（t＝3.412、2.274、5.602、4.648、－5.206，均P＜0.05）；GRASPS模型评分与CTRP3呈负相关（r＝－0.350，P＜0.05），与MMP-9呈正相关（r＝0.534，P＜0.05）；CTRP3与MMP-9呈负相关（r＝－0.642，P＜0.05）；GRASPS模型评分联合血清CTRP3和MMP-9预测出血转化的ROC曲线下面积为0.949（95%CI 0.913～0.985），明显高于各单独指标的ROC曲线（χ2＝7.154、7.981、6.031，均P＜0.05），诊断灵敏性为96.40%，特异性为79.40%。结论 GRASPS模型联合血清CTRP3、MMP-9对预测缺血性脑卒中患者溶栓后出血转化具有较高的应用价值。

Abstract：Objective To explore the value of GRASPS model combined with serum complement C1q/ tumor necrosis factor related protein 3（CTRP3）and matrix metalloproteinase-9 （MMP-9） in predicting hemorrhagic transformation after thrombolysis in patients with ischemic stroke. Methods A total of 135 patients with acute ischemic stroke in our hospital from January 2020 to January 2022 were selected, including 28 patients with hemorrhagic transformation and 107 patients without hemorrhagic transformation, the clinical data, GRASPS model score, serum CTRP3 and MMP-9 were compared. Results The incidence of atrial fibrillation was higher in patients with hemorrhagic transformation than in those without, showing a statistically significant difference（χ2＝37.703, P＜0.05）. Patients with hemorrhagic transformation had higher systolic and diastolic blood pressures at admission, higher GRASPS model scores, and higher MMP-9 levels but lower CTRP3 levels than those without hemorrhagic transformation, with statistically significant differences（t＝3.412, 2.274, 5.602, 4.648, －5.206, all P＜0.05）. There was a negative correlation between GRASPS model scores and CTRP3 （r＝－0.350, P＜0.05）, and a positive correlation between GRASPS model scores and MMP-9（r＝0.534, P＜0.05）. CTRP3 and MMP-9 were negatively correlated （r＝－0.642, P＜0.05）. The area under the ROC curve for predicting hemorrhagic transformation using a combination of GRASPS model scores, serum CTRP3, and MMP-9 was 0.949（95%CI 0.913～0.985）, significantly higher than the areas under the curves for each marker alone（χ2＝7.154, 7.981, 6.031, all P＜0.05）, with a diagnostic sensitivity of 96.40% and specificity of 79.40%. Conclusion GRASPS model combined with serum CTRP3 and MMP-9 provides a high application value in predicting hemorrhage transformation after thrombolysis in patients with ischemic stroke.

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参考文献

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