2023 年第 10 期 第 18 卷

血清泛连接蛋白3和胰岛素样生长因子1受体对急性脑梗死患者出血转化风险的预测价值

Predictive value of serum Pannexin 3 and insulin-like growth factor 1 receptor on the risk of hemorrhagic transformation in patients with acute cerebral infarction

作者：孙冬雪1刘满洲2王蓓蕾3刘嘉星4闫俊强1

英文作者：Sun Dongxue1 Liu Manzhou2 Wang Beilei3 Liu Jiaxing4 Yan Junqiang1

单位：1河南科技大学第一附属医院神经内科，洛阳471000；2河南科技大学第一附属医院肝胆外科，洛阳471000；3河南科技大学第一附属医院临床病理科，洛阳471000；4河南科技大学第一附属医院肿瘤外科，洛阳471000

英文单位：1Department of Neurology the First Affiliated Hospital of Henan University of Science and Technology Luoyang 471000 China; 2Department of Hepatobiliary Surgery the First Affiliated Hospital of Henan University of Science and Technology Luoyang 471000 China; 3Department of Clinical Pathology the First Affiliated Hospital of Henan University of Science and Technology Luoyang 471000 China; 4Department of Oncology Surgery the First Affiliated Hospital of Henan University of Science and Technology Luoyang 471000 China

关键词：急性脑梗死；出血转化；泛连接蛋白3；胰岛素样生长因子1受体

英文关键词：Acutecerebralinfarction;Hemorrhagictransformation；Pannexin3；Insulin-likegrowthfactor1receptor

• 摘要：

• 目的  探讨血清泛连接蛋白3（Panx3）、胰岛素样生长因子1受体（IGF1R）预测急性脑梗死（ACI）患者出血转化的价值。方法  选择2020年3月至2022年8月河南科技大学第一附属医院神经内科收治的187例ACI患者，根据是否发生出血转化将患者分为出血转化组（30例）和非出血转化组（157例）。所有ACI患者检测血清Panx3、IGF1R水平，收集临床相关资料。采用Logistic回归方法分析ACI患者出血转化的危险因素，受试者工作特征（ROC）曲线分析Panx3、IGF1R预测ACI患者出血转化的价值。结果  出血转化组血清Panx3水平高于非出血转化组［（5.6±1.5）μg/L比（3.0±1.0）μg/L］，IGF1R水平低于非出血转化组［（2.0±0.6）μg/L比（3.9±0.7）μg/L］（均P＜0.001）。Logistic回归分析结果显示，大面积梗死、高美国国立卫生研究院卒中量表评分、高Panx3是ACI患者发生出血转化的危险因素（比值比=2.866、3.494、1.865，95%置信区间：1.567～5.242、1.525～8.005、1.252～2.776，均P＜0.001），高IGF1R是ACI患者发生出血转化的保护因素（比值比=0.596，95%置信区间：0.408～0.870，P＜0.001）。Panx3、IGF1R单独预测ACI患者发生出血转化的曲线下面积为0.675、0.775，联合预测ACI患者发生出血转化的曲线下面积为0.909，大于Panx3、IGF1R单独预测（Z=4.244、2.756，均P＜0.05）。结论  ACI合并出血转化患者血清Panx3水平增高，IGF1R水平降低，联合Panx3和IGF1R可有效预测ACI患者出血转化。

• Objective  To investigate the value of serum Pannexin 3 (Panx3) and insulin-like growth factor 1 receptor (IGF1R) in predicting hemorrhagic transformation (HT) in patients with acute cerebral infarction (ACI). Methods  From March 2020 to August 2022, 187 patients with ACI admitted to the Department of Neurology, the First Affiliated Hospital of Henan University of Science and Technology were selected. According to whether HT occurred, the patients were divided into HT group (30 cases) and non-HT group (157 cases). All ACI patients were tested for the levels of serum Panx3 and IGF1R, and clinical relevant data were collected. Logistic regression method was used to analyze the risk factors of HT in patients with ACI, and the values of Panx3 and IGF1R in predicting HT in patients with ACI was analyzed by the receiver operating characteristic (ROC) curve. Results  The level of serum Panx3 in HT group was higher than that in non-HT group ［(5.6±1.5)μg/L vs (3.0±1.0)μg/L］, and the level of IGF1R was lower than that in non-HT group ［(2.0±0.6)μg/L vs (3.9±0.7)μg/L］ (both P＜0.001). Logistic regression analysis showed that large area infarction, high National Institutes of Health Stroke Scale score and high Panx3 were risk factors for HT in patients with ACI (odds ratio=2.866, 3.494, 1.865, 95% confidence interval: 1.567-5.242, 1.525-8.005, 1.252-2.776, all P＜0.001), and high IGF1R was a protective factor for HT in patients with ACI (odds ratio=0.596, 95% confidence interval: 0.408-0.870, P＜0.001). The areas under the curve of Panx3 and IGF1R alone predicting the occurrence of HT in patients with ACI were 0.675 and 0.775, and the area under the curve of the combination of Panx3 and IGF1R predicting the occurrence of HT in patients with ACI was 0.909, which was greater than that of Panx3 and IGF1R alone (Z=4.244, 2.756, both P＜0.05). Conclusion  The level of serum Panx3 increases and the level of IGF1R decreases in ACI patients with HT. The combination of Panx3 and IGF1R can effectively predict the HT in patients with ACI.