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目的 探究血浆中性粒细胞胞外诱捕网(NETs)水平与大动脉粥样硬化型缺血性脑卒中(LAA)患者病情严重程度及短期预后的相关性。方法 检测120例LAA患者(病例组)及60例健康体检者(对照组)血浆NETs主要成分瓜氨酸组蛋白(CitH)3及髓过氧化物酶(MPO)水平,收集相关临床资料。应用美国国立卫生研究院脑卒中量表(NIHSS)评分评估患者病情,NIHSS评分≤4分为神经功能缺损轻度组,5～15分为神经功能缺损中度组,≥16分为神经功能缺损重度组;发病后3个月应用改良Rankin量表(mRS)评分进行随访,将病例组分为预后不良组(mRS>2分)、预后良好组(mRS≤2分)。比较各组血浆CitH3、MPO水平;应用多因素Logistic回归分析病例组短期预后的影响因素;通过受试者工作特征(ROC)曲线分析血浆NETs水平对LAA患者短期预后的预测价值。结果 病例组吸烟史、高血压、入院时收缩压、空腹血糖(FPG)、中性粒细胞计数(NEUT)、纤维蛋白原(FIB)水平及血浆CitH3、MPO水平显著高于对照组,高密度脂蛋白胆固醇(HDL)水平显著低于对照组(P<0.05)。神经功能缺损中重度组血浆CitH3、MPO水平显著高于轻度组(P<0.05);进一步分析显示,LAA患者NIHSS评分与血浆CitH3、MPO水平呈正相关(r=0.482、0.449,均P<0.05)。预后不良组血浆CitH3、MPO水平显著高于预后良好组(P<0.05)。Logistic回归分析显示FIB、APTT、CitH3、MPO水平是患者短期预后不良的危险因素(P<0.05)。ROC曲线结果提示,血浆CitH3联合血浆MPO预测LAA患者短期预后不良的曲线下面积(AUC)为0.871,敏感度为81.58%,特异度为84.15%。结论 血浆NETs水平与LAA患者神经功能损害程度及预后不良相关,联合检测血浆CitH3、MPO水平能有效预测LAA患者短期预后。
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基本信息:
中图分类号:R743.3
引用信息:
[1]齐鹏,张柏扬,白禹,等.血浆NETs水平与大动脉粥样硬化型缺血性脑卒中患者病情严重程度及短期预后的相关性[J].中国老年学杂志,2026,46(17):3088-3092.
基金信息:
黑龙江省卫健委科技计划（20220303070945）
2026-09-08
2026-09-08