缺血性脑卒中病人外周血中NDRG2蛋白、mTOR含量与预后的相关性分析

    Correlation analysis of NDRG2 protein and mTOR in peripheral blood of ischemic stroke patients with prognosis

    • 摘要:
      目的研究缺血性脑卒中病人外周血中N-Myc下游调节基因2(NDRG2)蛋白、哺乳动物雷帕霉素靶蛋白(mTOR)的含量,并分析其与病人预后的相关性。
      方法选取缺血性脑卒中病人300例为观察组,根据神经功能缺损评分分为轻度组(n=99)、中度组(n=113)、重度组(n=88),根据出院90 d改良Rankin量表(mRS)分为预后不良组(mRS>3分,n=108)与预后良好组(mRS≤3分,n=192),同期随机选取体检的健康者278名为对照组。收集研究对象的一般资料并检测常规生化指标水平;利用酶联免疫吸附法(ELISA)检测外周血NDRG2蛋白、mTOR含量,Pearson法分析NDRG2蛋白、mTOR与缺血性脑卒中病人常规生化指标的相关性;病人出院后随访3个月,利用ROC曲线分析NDRG2蛋白、mTOR含量预测缺血性脑卒中预后不良的价值。
      结果观察组病人外周血中NDRG2蛋白与mTOR含量均显著高于对照组(P < 0.01);病人外周血中NDRG2蛋白与mTOR含量神经功能缺损重度组高于中度组和轻度组,中度组亦高于轻度组(P < 0.05);缺血性脑卒中病人外周血NDRG2蛋白、mTOR含量分别与LDL-C、TG、TC、Hcy、D-D、Lp(a)、Hs-CRP呈正相关关系(P < 0.05~P < 0.01),与HDL-C呈负相关关系(P < 0.01)。预后良好组病人外周血中NDRG2蛋白与mTOR含量均低于预后不良组(P < 0.01);外周血NDRG2蛋白、mTOR含量评估缺血性脑卒中预后不良AUC分别为0.733、0.952,敏感度分别为62.04%、89.81%,特异度分别为76.56%、89.58%;二者联合评估缺血性脑卒中AUC为0.958,敏感度为86.11%,特异度为93.23%。
      结论缺血性脑卒中病人外周血中NDRG2蛋白、mTOR均呈高水平,二者联合检测对缺血性脑卒中预后不良具有较高的预测价值。

       

      Abstract:
      ObjectiveTo explore the expression levels of N-Myc downstream regulated gene 2 (NDRG2) protein and mammalian target of rapamycin (mTOR) in peripheral blood of patients with ischemic stroke, and analyze its correlation with patient prognosis.
      MethodsA total of 300 patients with ischemic stroke were selected as the observation group, and divided into mild group (n=99), moderate group (n=113) and severe group (n=88) according to the National Institute of Health stroke scale. According to the modified Rankin scale (mRS) 90 days after discharge, they were divided into poor prognosis group (mRS>3, n=108) and good prognosis group (mRS ≤ 3, n=192). At the same time, 278 healthy subjects were randomly selected as the control group. The clinical data of patients were collected, enzyme-linked immunosorbent assay was used to detect the expression levels of NDRG2 protein and mTOR in peripheral blood. Pearson method was used to analyze the correlation between NDRG2 protein, mTOR, and routine biochemical indicators in patients with ischemic stroke. The patients were followed up for 3 months after discharge, and the ROC curve was used to analyze the value of NDRG2 protein and mTOR in predicting poor prognosis of ischemic stroke.
      ResultsThe levels of NDRG2 protein and mTOR in the peripheral blood of patients in the observation group was significantly higher than those in the control group (P < 0.01). The levels of NDRG2 protein and mTOR in the peripheral blood of patients with severe neurological deficits were higher than those in the moderate and mild groups, and which in the moderate group was also higher than those in the mild group (P < 0.05). The peripheral blood NDRG2 protein and mTOR levels in ischemic stroke patients were positively correlated with low-density lipoprotein cholesterol (LDL-C), triacylglycerol (TG), total cholesterol (TC), homocysteine (Hcy), D-dimer (D-D), lipoprotein a, hypersensitivity C-reactive protein (Hs-CRP) (P < 0.05 to P < 0.01), and negatively correlated with high-density lipoprotein cholesterol (HDL-C) (P < 0.01). The levels of NDRG2 protein and mTOR in peripheral blood of patients with good prognosis were lower than those of patients with poor prognosis (P < 0.01). The peripheral blood NDRG2 protein and mTOR levels were evaluated for poor prognosis in ischemic stroke, with AUC of 0.733 and 0.952, sensitivity of 62.04% and 89.81%, and specificity of 76.56% and 89.58%, respectively. The AUC of the combined assessment of ischemic stroke was 0.958, with a sensitivity of 86.11% and a specificity of 93.23%.
      ConclusionsThe levels of NDRG2 protein and mTOR in peripheral blood of patients with ischemic stroke are both high. The combined detection of NDRG2 protein and mTOR has high predictive value for poor prognosis of ischemic stroke.

       

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