目的:观察急性脑梗死患者血清泛素羧基末端水解酶-1(ubiquitin C-terminal hydrolase-L1,UCH-L1)和血清胶质纤维酸性蛋白(serum glial fibrillary acidic protein,GFAP)的临床表达水平,并探讨二者对脑梗死患者的临床意义。方法:选取重庆市肿瘤医院在2014年1月至2016年2月期间收治的80例急性脑梗死患者作为观察组,另选取同时段来院做体格检查的80例健康者作为对照组。分别检测两组研究对象的血清UCH-L1和GFAP的表达水平。结果:UCH-L1诊断脑梗死的敏感度为75.0%,特异度为87.5%;GFAP诊断脑梗死的敏感度为81.3%,特异度为90.0%。UCH-L1和GFAP的受试者工作特征(receiver operating characteristic,ROC)曲线下面积分别为0.670及0.757。两组研究对象在年龄、性别、饮酒、吸烟、糖尿病、高脂血症等一般情况中比较,差异无统计学意义(P〉0.05);观察组患者患高血压的比例明显高于对照组(P〈0.05);经Spearson/Pearson分析显示血清UCH-L1与GFAP水平与高血压呈正比,与性别、年龄、糖尿病、高血脂、饮酒、吸烟等因素无相关性;观察组患者不同发病时间一般资料的比较,差异无统计学意义(P〉0.05),血清UCH-L1和GFAP表达水平明显高于对照组(P〈0.05);在不同发病时间两组患者血清UCH-L1和GFAP表达水平差异无统计学意义(P〉0.05);轻、中、重型3组患者的血清UCH-L1和GFAP表达水平高于对照组(P〈0.05);中、重型患者血清UCH-L1和GFAP表达水平高于轻型(P〈0.05);观察组患者在不同发病时间里血清UCH-L1和GFAP表达水平与梗死灶大小差异有统计学意义(P〈0.05);Pearson相关性分析结果示血清UCH-L1和GFAP表达水平呈正相关(r=0.634,P=0.001)。结论:在急性脑梗死患者中早期血清UCH-L1和GFAP的表达水平明显升高,与脑梗死的病情严重程度有一定的相关性,可为临床上早期诊断及治疗提供依据。
Objective: To determine expression levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) and serum glial fibrillary acidic protein (GFAP) in patients with acute cerebral infarction and their clinical significance. Methods: A total of 80 patients with acute cerebral infarction in Chongqing Cancer Hospital from January 2014 to February 2016 were enrolled as an observation group. Another 80 healthy people served as a control group. The expression levels of UCH-L1 and GFAP in the 2 groups were detected. Results: Sensibility and specificity for UCH-L1 and GFAP were 75.0%, 87.5% and 81.3%, 90.0%, respectively. Receiver operating characteristic curve areas of UCH-LI and GFAP were 0.670 and 0.757, respectively. There were no significant significance in age, gender, drinking, smoke, diabetes, and hyperlipidemia in the 2 groups (P〉0.05). High blood pressure rate in the observation group was higher than that in the control group (P〈O.05). Spearson/Pearson analysis showed that serum UCH-L1 and GFAP levels were positively correlated with hypertension, but they were negatively correlated with sex, age, diabetes, hyperlipidemia, alcohol consumption, smoking, and other factors. General data at different time in the observation group was not statistically different (P〉0.05). The expression levels of UCH-L1 and GFAP in the observation group was higher than that in the control group (P〈0.05). UCH-L1 and GFAP levels at different time in the 2 groups were not statistically different (P〉0.05). UCH-L1 and GFAP levels in the light, medium, and heavy groups were higher than those in the control group (P〈0.05), while UCH-L1 and GFAP levels in the medium and heavy groups were higher than those in the light group (P〈O.05). There was significant difference between levels of UCH-L1 or GFAP and infarction size at different time in the observation group (P〈0.05). The results of Pearson correlation analysis showed that the levels of serum UCH-L1 and GFAP were positively correlated (r