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白细胞介素-6 联合血清神经元特异性烯醇化酶对急性缺血性脑卒中预后的预测价值。

Predictive value of interleukin-6 combined with serum neuron-specific enolase on the prognosis of acute ischemic stroke.

机构信息

Department of Emergency, The First Hospital of Hebei Medical Univerisity, Shijiazhuang, China.

Department of General Practice, The First Hospital of Hebei Medical Univerisity, Shijiazhuang, China.

出版信息

Clin Neurol Neurosurg. 2024 Sep;244:108406. doi: 10.1016/j.clineuro.2024.108406. Epub 2024 Jun 24.

Abstract

OBJECTIVE

To explore the prognostic value of interleukin-6 (IL-6) combined with serum neuron specific enolase (NSE) in arterial atherosclerotic ischemic stroke.

METHODS

116 patients with arterial atherosclerotic ischemic stroke admitted to the emergency ward of our Hospital were retrospectively analyzed. According to the score of modified Rankin scale (mRS) at 90 days after discharge, the patients were divided into the poor prognosis group (mRS > 2, n = 32) and the good prognosis group (mRS ≤ 2, n = 84). Activities of Daily Living (ADL) was used to evaluate the level of independence in activities of daily living after treatment.

RESULTS

The NIHSS score (14.91 ± 5.20 vs. 9.43 ± 4.30, P < 0.001), IL-6 (11.30 ± 3.11 vs. 6.75±1.28, P < 0.001) and NSE levels (12.47 ± 4.69 vs. 6.42 ± 1.32, P<0.001) in poor prognosis group were higher than those in the good prognosis group. At 90 days post-discharge, 100 % of the good prognosis group had ADL scores over 60, while in the poor prognosis group, 46.88 % scored 40-60, 40.63 % scored 20-40, 9.38 % scored under 20, and 3.13 % died. The AUC of NSE was 0.906 (95 % CI: 0.847-0.965, P < 0.001), the best cut-off value was 7.445 ng/mL, and the sensitivity and specificity were 75.0 % and 82.1 %, respectively. The AUC for IL-6 combined with NSE increased to 0.965 (95 %CI: 0.934-0.997, P < 0.001), and the sensitivity and specificity increased to 80.2 % and 92.9 %, respectively.

CONCLUSION

IL-6 ≥ 6.805 pg/mL and NSE ≥ 7.445 ng/mL were independently associated with poor prognosis in patients with AIS, and the combined testing of the two indicators had a higher predictive value. These results suggested that the combined assay of IL-6 and NSE could be a novel marker for predicting poor prognosis in AIS.

摘要

目的

探讨白细胞介素-6(IL-6)联合血清神经元特异性烯醇化酶(NSE)在动脉粥样硬化性缺血性卒中患者预后评估中的价值。

方法

回顾性分析我院急诊收治的 116 例动脉粥样硬化性缺血性卒中患者的临床资料。根据出院 90 天后改良 Rankin 量表(mRS)评分,将患者分为预后不良组(mRS>2,n=32)和预后良好组(mRS≤2,n=84)。采用日常生活活动能力量表(ADL)评估治疗后日常生活活动的独立水平。

结果

预后不良组 NIHSS 评分(14.91±5.20 分比 9.43±4.30 分,P<0.001)、IL-6(11.30±3.11 分比 6.75±1.28 分,P<0.001)和 NSE 水平(12.47±4.69 分比 6.42±1.32 分,P<0.001)均高于预后良好组。出院后 90 天,预后良好组 100%的患者 ADL 评分均大于 60 分,而预后不良组中,46.88%的患者 ADL 评分为 40-60 分,40.63%的患者 ADL 评分为 20-40 分,9.38%的患者 ADL 评分小于 20 分,3.13%的患者死亡。NSE 的 AUC 为 0.906(95%CI:0.847-0.965,P<0.001),最佳截断值为 7.445ng/mL,敏感度和特异度分别为 75.0%和 82.1%。IL-6 联合 NSE 的 AUC 增加至 0.965(95%CI:0.934-0.997,P<0.001),敏感度和特异度分别增加至 80.2%和 92.9%。

结论

IL-6≥6.805pg/mL 和 NSE≥7.445ng/mL 与 AIS 患者预后不良独立相关,联合检测两项指标具有更高的预测价值。这些结果表明,IL-6 和 NSE 的联合检测可能成为 AIS 预后不良的新型标志物。

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