本文選題：Sestrin2蛋白　切入點(diǎn)：超敏C反應(yīng)蛋白　出處：《延邊大學(xué)》2017年碩士論文

【摘要】：目的:檢測(cè)急性缺血性腦卒中患者血清Sestrin2含量,探討Sestrin2對(duì)急性缺血性腦卒中患者的病程評(píng)估及預(yù)后價(jià)值。方法:①連續(xù)收集2016年9月至2017年1月就診于延邊大學(xué)附屬醫(yī)院神經(jīng)內(nèi)科住院的急性缺血性腦卒中患者,共88例,其中男性為45例,女性為43例,平均年齡(59.06±3.41)歲。②對(duì)照組隨機(jī)選取相同時(shí)期年齡和性別相匹配的非腦卒中個(gè)體,共88例,其中男性為46例,女性為42例,平均年齡(58.68±3.36)歲。對(duì)急性缺血性腦卒中患者嚴(yán)重程度的評(píng)估,入院當(dāng)天依據(jù)美國國立衛(wèi)生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)評(píng)分評(píng)估神經(jīng)功能缺損程度,根據(jù)評(píng)分結(jié)果分為輕型組(NIHSS≤3分),中型組(NIHSS 4-8分),重型組(NIHSS≥8分)。根據(jù)急性卒中治療低分子肝素試驗(yàn)(Trial of Org 10172 in Acute Stroke Treatment,TOSAT)分型將缺血性腦卒中患者分為4個(gè)亞型:大動(dòng)脈粥樣硬化型、小動(dòng)脈閉塞型、心源性栓塞型、不明原因型。根據(jù)改良Rankin(mRS)評(píng)分標(biāo)準(zhǔn)對(duì)出院后3個(gè)月缺血性腦卒中患者進(jìn)行日常生活能力評(píng)估,分為預(yù)后良好組(mRS 0-2分)和預(yù)后不良組(mRS 3-5分)。采用ELISA方法檢測(cè)血清Sestrin2(SESN2)的濃度。結(jié)果:1.缺血性腦卒中組與對(duì)照組一般資料比較結(jié)果顯示,缺血性腦卒中患者高血壓、糖尿病、血脂異常、吸煙、飲酒、TG、LDL-L、GLU、Hey、Hs-CRP水平均明顯高于對(duì)照組(P0.05);然而,HDL-L水平明顯低于對(duì)照組(P0.05);兩組的性別、年齡、BMI、脈搏、TC水平無明顯差異(P0.05)。2.與對(duì)照組相比,缺血性腦卒中患者血清Sestrin2水平明顯升高(13.85±3.00 ng/ml vs.11.91±1.95ng/m1,P=0.001)。3.血清Sestrin2含量與缺血性腦卒中嚴(yán)重程度相關(guān)性結(jié)果顯示,血清SESN2含量在NHISS評(píng)分輕、中、重型三組之間比較無明顯差異(F=1.700,P=0.189);在TOSAT分型的四組分型之間血清Sestrin2含量比較無明顯差異(F=0.728,P=0.538)。4.血清Sestrin2含量與缺血性腦卒中預(yù)后相關(guān)性結(jié)果顯示,血清Sesn2含量在預(yù)后良好組與預(yù)后不良組之間比較差異無統(tǒng)計(jì)學(xué)意義(T=1.096,P=0.276)。5.血清Sestrin2水平與各參數(shù)的相關(guān)分析結(jié)果顯示,無論是缺血性腦卒中患者還是對(duì)照組的血清Sestrin2水平均與血糖呈正相關(guān),分別為(r=0.254,P=0.017;r=0.229,P=0.032)。在缺血性腦卒中患者中,血清Sestrin2水平有糖尿病史、吸煙史、飲酒史均明顯高于無病史(P=0.015,P=0.011,P=0.009)。6.多因素Logistic回歸模型分析顯示血清Sestrin2(OR=0.791,95%CI[0.647-0.966],P =0.022)、Hs-CRP(OR=0.485,95%CI[0.329-0.717],P0.001)、血脂異常(OR=4.290,95%CI[1.517-12.131],P =0.006)是缺血性腦卒中的獨(dú)立危險(xiǎn)因素。7.根據(jù)Logistic模型結(jié)果,用Sestrin2、Hs-CRP、HCY構(gòu)建的ROC曲線表明,①Se6trn2曲線下面積(0.705,95%CI[0.628-0.782],P0.001);cut off值為13.15,靈敏度為77.3%,特異性為55.7%。②Hs-CRP曲線下面積(0.767,95%CI[0.697-0.837],P0.001);cut off 值為 1.245,靈敏度為 81.8%,特異性為 64.8%。③HCY曲線下面積(0.580,95%CI[0.495-0.666],P=0.065);cut off 值為 12.245,靈敏度為44.6%,特異性為71.6%。結(jié)論:1.急性缺血性腦卒中血清Sestrin2含量明顯升高,提示Sestrin2參與急性缺血性腦卒中病理機(jī)制。2.無論是對(duì)照組還是缺血性腦卒中組的血清Sestrin2含量均與血糖呈正相關(guān)。3.有糖尿病史、吸煙史、飲酒史的缺血性腦卒中患者血清Sestrin2水平明顯高于無病史的患者。4.血清Sestrin2是缺血性腦卒中的獨(dú)立危險(xiǎn)因素。5.血清Sestrin2是缺血性腦卒中潛在的診斷及預(yù)防的生物標(biāo)志物。
[Abstract]:Objective: to detect the acute ischemic stroke patients serum Sestrin2 content, investigate the value of Sestrin2 in the course of evaluation and prognosis of patients with acute ischemic stroke. Methods: 1. From September 2016 to January 2017 in the Affiliated Hospital of Yanbian University Department of Neurology in acute ischemic stroke patients, a total of 88 cases, including 45 cases of male, female 43 cases, the average age (59.06 + 3.41). The control group were randomly selected non stroke individuals of the same age and sex matched, a total of 88 cases, including 46 cases of male, female 42 cases, average age (58.68 + 3.36) years old. To evaluate the severity of patients with acute ischemic stroke. On the day of admission, according to the National Institutes of Health Stroke Scale (National Institute of Health Stroke Scale, NIHSS) was evaluated according to the degree of neurologic impairment were divided into mild group (NIHSS = 3) Medium sized group (NIHSS, 4-8), severe group (NIHSS = 8). According to the test of low molecular weight heparin for the treatment of acute stroke (Trial of Org 10172 in Acute Stroke Treatment, TOSAT) type of the ischemic stroke patients were divided into 4 subtypes: large artery atherosclerosis, arterial occlusion, cardioembolism type of unknown type. According to the modified Rankin (mRS) standard for evaluation of evaluation of the ability of daily life in patients with ischemic stroke 3 months after discharge, divided into good prognosis group (mRS 0-2) and poor prognosis group (mRS 3-5). ELISA method was used to detect serum Sestrin2 (SESN2) concentration. 1.: ischemic stroke group and control group data comparison showed that hypertension, ischemic stroke in patients with diabetes, dyslipidemia, smoking, alcohol, TG, LDL-L, GLU, Hey, Hs-CRP were significantly higher than the control group (P0.05); however, the level of HDL-L was significantly lower than the control group (P0 .05); two groups of gender, age, BMI, pulse, no significant differences in the level of TC (P0.05).2. compared with the control group, ischemic stroke patients serum Sestrin2 level increased significantly (13.85 + 3 ng/ml vs.11.91 + 1.95ng/m1, P=0.001).3. content of serum Sestrin2 and ischemic stroke severity, correlation analysis showed that serum SESN2 the content of NHISS scores in the light, heavy, there were no significant difference between the three groups (F=1.700, P=0.189); between four groups of type TOSAT type serum Sestrin2 content had no significant difference (F=0.728, P=0.538).4. serum Sestrin2 content and prognosis of ischemic stroke related results show that the content of serum Sesn2 in good prognosis group and poor prognosis group had no significant difference (T=1.096, P=0.276).5. correlation analysis of serum Sestrin2 level and the parameters of the results showed that both in patients with ischemic stroke or control The serum level of Sestrin2 group were positively correlated with blood glucose, respectively (r=0.254, P=0.017; r=0.229, P=0.032). In ischemic stroke patients, the serum level of Sestrin2 had a history of diabetes, smoking history, drinking history were significantly higher than those without history (P=0.015, P=0.011, P=0.009) regression analysis showed that serum Sestrin2.6. multi factor Logistic (OR=0.791,95%CI[0.647-0.966], P, =0.022) Hs-CRP (OR=0.485,95%CI[0.329-0.717], P0.001), dyslipidemia (OR=4.290,95%CI[1.517-12.131] P, =0.006.7.) is an independent risk factor for ischemic stroke according to the result of Logistic model, Sestrin2, Hs-CRP, ROC curve constructed by HCY showed that the area under the Se6trn2 curve (0.705,95%CI[0.628-0.782], P0.001); cut off = 13.15, the sensitivity was 77.3%, specificity was 55.7%. the area under the Hs-CRP curve (0.767,95%CI[0.697-0.837], P0.001 cut); the off value is 1.245, the sensitivity was 81.8 %, the specificity was 64.8%., the area under the HCY curve (0.580,95%CI[0.495-0.666], P=0.065); cut off = 12.245, the sensitivity was 44.6%, specificity was 71.6%. conclusion: 1. patients with acute ischemic stroke and serum Sestrin2 levels were significantly increased, suggesting that Sestrin2 involved in the pathological mechanism of acute ischemic stroke.2. both in control group and ischemic stroke group serum Sestrin2 levels were positively correlated with blood glucose.3. have a history of diabetes, smoking history, drinking history of ischemic stroke in patients with Sestrin2 were higher than the patients with a history of.4. serum Sestrin2 is an independent risk factor of.5. Sestrin2 in serum of ischemic stroke is a biomarker for diagnosis and prevention of ischemic stroke potential.

【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3;R446.1

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