田章林;龙波;熊密;董语涵;魏有东;

• 1:重庆医科大学附属第一医院
• 2:重庆神经生物学重点实验室

摘要(Abstract)：

目的 探究急性缺血性脑卒中（AIS）患者血清白介素1受体关联激酶4(IRAK4)浓度及其与疾病严重程度、患者功能预后的相关性。方法 纳入2020-09—2021-02于重庆医科大学附属第一医院神经内科住院的发病时间在72 h内的AIS患者（AIS组）134例及健康对照者（HC组）31例，使用急性IS Org 10172治疗试验（TOAST）分型标准将AIS组患者分为5个亚组，所有受试者第2天清晨空腹抽取外周静脉血。收集并分析2组基线资料和临床资料，基线资料包括受试者性别、年龄、饮酒史、吸烟史等，临床资料包括美国国立卫生研究院卒中量表（NIHSS）评分、实验室生化指标等。使用酶联免疫吸附分析试剂盒测定血清中IRAK4的浓度，分析5个亚组血清IRAK4是否存在统计学差异及IRAK4与NIHSS评分是否具有相关性，通过受试者工作特征（ROC）曲线及曲线下面积（AUC）评估IRAK4对缺血性脑卒中的预测价值。使用改良Rankin量表（mRS）评估3个月后AIS患者的功能预后，以AIS患者功能预后为因变量，根据单因素分析中的变量（P<0.05）对AIS患者功能预后的影响因素进一步行多因素Logistic回归分析。结果 AIS组与HC组受试者性别、年龄、饮酒史、吸烟史、高脂血症、冠心病差异均无统计学意义（均P>0.05）。与HC组相比，AIS组患者血清IRAK4浓度显著升高[（364.69±43.32）μg/L vs(323.05±48.31)μg/L,P<0.05]；经ROC曲线分析，IRAK4的AUC值为0.728(95%CI:0.628～0.827,P<0.01)，最佳截断值为303.4μg/L，约登指数为0.384，灵敏度和特异度分别为93.3%和45.2%。血清IRAK4浓度与入院NIHSS评分无相关性（r=0.079,P=0.365）。AIS患者5个亚组之间血清IRAK4浓度差异无统计学意义（P>0.05）。与预后良好组相比，预后不良组血清IRAK4浓度无统计学差异[（368.62±41.05）μg/L vs(361.95±44.88)μg/L,P=0.382]。结论 IRAK4在AIS患者血清中表达增加，或许可作为早期识别和诊断AIS的生物学指标之一，但与患者疾病严重程度及功能预后无相关性。

关键词(KeyWords)： 急性缺血性脑卒中;白介素1受体关联激酶4;血清;疾病严重程度;功能预后;相关性

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 田章林;龙波;熊密;董语涵;魏有东;

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