[1]王丽香 李强 贾晓菲等.急性脑梗死静脉溶栓患者血清Galectin-1,Galectin-3的水平变化及其临床意义[J].卒中与神经疾病杂志,2022,29(01):13-18.[doi:10.3969/j.issn.1007-0478.2022.01.003]
　Wang Lixiang,Li Qiang,Jia Xiaofei,et al.Changes and significance of galectin-1 andgalectin-3 in serum of patients with acute cerebral infarct after intravenous thrombolysis[J].Stroke and Nervous Diseases,2022,29(01):13-18.[doi:10.3969/j.issn.1007-0478.2022.01.003]
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急性脑梗死静脉溶栓患者血清Galectin-1,Galectin-3的水平变化及其临床意义()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第29卷
期数:
2022年01期
页码:
13-18
栏目:
论 著
出版日期:
2022-02-15

文章信息/Info

Title:
Changes and significance of galectin-1 andgalectin-3 in serum of patients with acute cerebral infarct after intravenous thrombolysis
文章编号:
1007-0478(2022)01-0013-06
作者:
王丽香 李强 贾晓菲等
271100 济南市第八人民医院神经内科(王丽香 李强 周雪梅 于振江); 济南市钢城区人民医院(贾晓菲)
Author(s):
Wang Lixiang;  Li Qiang;  Jia Xiaofei;  et al
Department of Neurology, Jinan 8th People’s Hospital, Jinan Shandong 271100
关键词:
半乳糖凝集素1 半乳糖凝集素3 急性脑梗死 预后 认知功能
Keywords:
Galectin-1 Galectin-3 Acute cerebral infarct Prognosis Cognitive function
分类号:
R743.3
DOI:
10.3969/j.issn.1007-0478.2022.01.003
文献标志码:
A
摘要:
目的 探讨急性脑梗死(Acute cerebral infarct,ACI)患者静脉溶栓前后血清中半乳糖凝集素1(Galectin-1,Gal-1)和半乳糖凝集素3(Galectin-3,Gal-3)的水平变化及其临床意义。方法 选取接受静脉溶栓的86例ACI患者作为观察组,根据美国国立卫生研究所卒中量表(National institutes of health stroke scale,NIHSS)评分将其分为轻型组31例、中型组29例、重型组26例; 治疗结束后随访6个月,根据改良Rankin量表(Modified Rankin scale,mRS)评估预后并分为预后良好组62例和预后不良组24例,根据蒙特利尔认知评估量表(Mentreal congnitive assessment,MoCA)评估认知功能并分为认知障碍(Cognitive impairment,CI)组30例和非认知障碍(Non-cognitive impairment,NCI)组56例。另选30例本院体检健康者作为对照组。应用酶联免疫吸附法测定2组血清Gal-1,Gal-3的水平,分析其与NIHSS,mRS,MoCA的相关性及对静脉溶栓患者预后的预测价值。结果(1)ACI患者静脉溶栓后血清Gal-1,Gal-3水平较静脉溶栓前逐渐下降,但溶栓后第30 d血清Gal-1水平较溶栓后第7 d升高(P<0.05);(2)ACI患者静脉溶栓前血清Gal-1,Gal-3水平明显高于对照组(P<0.05); 重型组Gal-1,Gal-3水平最高,中型组次之,轻型组最低(P<0.05);(3)ACI患者静脉溶栓后第1、7、30 d预后不良组血清Gal-3水平均高于预后良好组(P<0.05),CI组均高于NCI组(P<0.05); 溶栓后第30 d预后良好组血清Gal-1水平高于预后不良组(P<0.05),而CI组低于NCI组(P<0.05); 其余时间点预后良好组血清Gal-1水平均低于预后不良组(P<0.05),而CI组则高于NCI组(P<0.05);(4)Pearson分析显示,溶栓前血清Gal-1,Gal-3水平与NIHSS评分均呈正相关(r=0.762,0.831,P<0.05); 溶栓后第30 d血清Gal-1水平与mRS评分、MoCA评分分别呈负相关、正相关(r=-0.773,0.820,P<0.05); 溶栓后第1、7、30 d血清Gal-3水平与mRS评分均呈正相关(r=0.817,0.741,0.675,P<0.05),而与MoCA评分均呈负相关(r=-0.842,-0.763,-0.677,P<0.05);(5)绘制受试者工作特征(Receiver operating characteristic,ROC)曲线显示,溶栓后第30 d血清Gal-1水平预测ACI患者静脉溶栓后预后良好的曲线下面积(AUC)为0.814(95% CI=0.697～0.877); 溶栓后第1、7 d的血清Gal-3水平预测ACI患者静脉溶栓后预后不良的AUC分别为0.886(95% CI=0.799～0.945)、0.714(95% CI=0.617～0.804)。结论 血清Gal-1,Gal-3的表达水平与ACI患者静脉溶栓后的预后相关,对评估患者的预后具有重要价值。
Abstract:
Objective To investigate the expression and clinical significance of the levels of galectin-1 and galectin-3 in serum of patients with acute cerebral infarct(ACI)before and after intravenous thrombolysis.Methods 86 patients with ACI who all received intravenous thrombolysis therapy were selected as the observation group they were further divided into the mild subgroup(31cases), moderate subgroup(29cases), and severe subgroup(26cases)according to the NIH Stroke Scale(NIHSS).All the patients with ACI were followed up for 6 months, they were divided into the good prognosis subgroup(62 cases)and poor prognosis subgroup(24 cases)according to the modified Rankin Scale(mRS)score, and also divided into the cognitive impairment subgroup(30 cases)and non-cognitive impairment subgroup(56 cases)according to the Montreal Cognitive Assessment scale(MoCA)score. Another 30 healthy subjects were selected as control group. The levels of galectin-1 and galectin-3 in serum of the two groups were detected by enzyme-linked immunosorbent assay,then the correlations between galectin-1 and galectin-3 expressive levels and NIHSS, mRS, MoCA score were analyzed, and the predictive values of galectin-1 and galectin-3 expressive levels in neurological prognosis were also analyzed.Results(1)Before intravenous thrombolysis, the serum levels of galectin-1and galectin-3in the observation group were significantly higher than those in the control group(P<0.05).After intravenous thrombolysis, the levels of galectin-1 and galectin-3 in patients with ACI began to decrease gradually, but the level of galectin-1 on the 30th day was higher than before.(2)Before intravenous thrombolysis, the levels of galectin-1and galectin-3 in the severe subgroup were the highest; those in the moderate subgroup were the second; and those in the mild subgroup were the lowest(P<0.05).(3)After intravenous thrombolysis, the levels of galectin-3 in the poor prognosis subgroup were all higher than those in the good prognosis subgroup(P<0.05)on the 1st day,7th day and 30th day, while the levels of galectin-3in the cognitive impairment subgroup were also higher than those in the non-cognitive impairment subgroup(P<0.05). On the 30th day, the levels of galectin-1 in the good prognosis subgroup were higher than those in the poor prognosis subgroup(P<0.05), while the levels of galectin-1 in the cognitive impairment subgroup were lower than those in the non-cognitive impairment subgroup(P<0.05). At the other time points, the levels of galectin-1 in the good prognosis subgroup were lower than those in the poor prognosis subgroup(P<0.05), while the levels of galectin-1 in the cognitive impairment subgroup were higher than those in the non-cognitive impairment subgroup(P<0.05).(4)Pearson analysis showed that the levels of galectin-1 and galectin-3 were positively correlated with NIHSS score before intravenous thrombolysis. After intravenous thrombolysis, the level of galectin-1 on the 30th day was negatively correlated with mRS score(r=-0.773, P<0.05), while positively correlated with MoCA score(r=0.820, P<0.05); the levels of galectin-3 on the 1st day,7th day and 30th day were all positively correlated with mRS score(r=0.817,0.741, 0.675, P<0.05), while negatively correlated with MoCA score(r=-0.842,-0.763,-0.677, P<0.05).(5)ROC analysis showed that the levels of galectin-1 on the 30th day hada certain value in predicting the good prognosis of ACI patients after intravenous thrombolysis, and the area under the curve(AUC)was 0.814(95%CI=0.697～0.877); the levels of galectin-3 on the 1st and7th day had some value in predicting the poor prognosis of ACI patients after intravenous thrombolysis, and the AUC were 0.886(95%CI=0.799～0.945)、0.714(95%CI=0.617～0.804).Conclusion The expressive levels of serum galectin-1 and galectin-3was related to the prognosis of patients with ACI after intravenous thrombolysis, and they could provide reference for the evaluation of neurological prognosis of patients.

参考文献/References:

[1] Benjamin EJ, Virani SS, Callaway CW, et al. Heart disease and stroke statistics-2018 update: a report from the American heart association[J]. Circulation, 2018, 137(12): e67-e492.
[2] Liu YX, Cao QM, Ma BC. Pathogens distribution and drug resistance in patients with acute cerebral infarction complicated with diabetes and nosocomial pulmonary infection[J]. BMC Infect Dis, 2019, 19(1): 603.
[3] Tseng YJ, Hu RF, Lee ST, et al. Risk factors associated with outcomes of recombinant tissue plasminogen activator therapy in patients with acute ischemic stroke[J]. Int J Environ Res Public Health, 2020, 17(2): 618.
[4] 周秉博,王晓宏,杨军.急性脑梗死患者重组组织型纤溶酶原激活剂静脉溶栓后出血性转化的危险因素分析[J].中国医科大学学报,2017,46(12):1101-1104, 1110.
[5] Jayaraj RL, Azimullah S, Beiram R, et al. Neuroinflammation: friend and foe for ischemic stroke[J]. J Neuroinflammation, 2019, 16(1): 142.
[6] Nonaka M, Fukuda M. Galectin-1 for neuroprotection? [J]. Immunity, 2012, 37(2):187-189.
[7] Starossom SC, Mascanfroni ID, Imitola J, et al. Galectin-1 deactivates classically activated microglia and protects from inflammation-induced neurodegeneration[J]. Immunity, 2012, 37(2): 249-263.
[8] 罗茗刈,赵红卫,陈海丹.半乳糖凝集素1对神经的保护作用[J].长江大学学报(自科版),2014,11(1):100-103.
[9] 李金霞,王学新,陈琦,等.Galectin-3在动脉粥样硬化相关性脑卒中的研究进展[J].中国实用神经疾病杂志,2021,24(10):915-920.
[10] Lytton WW, Arle J, Bobashev G, et al. Multiscale modeling in the clinic: diseases of the brain and nervous system[J]. Brain Inform, 2017, 4(4): 219-230.
[11] 孙洋洋,周李娅,葛晓利,等.急性缺血性脑卒中静脉溶栓预后预警指标研究[J].中华急诊医学杂志,2019,28(2):214-218.
[12] Ruparelia N, Choudhury R. Inflammation and atherosclerosis: what is on the horizon? [J]. Heart, 2020, 106(1):80-85.
[13] 唐彦,张凡,窦艳霞,等.急性脑梗死患者血清Galectin-3、TIMP-1、CaM水平与神经功能缺损程度及预后的关系[J].山东医药,2020,60(17):58-61.
[14] Tan K, Cheung CL, Lee A, et al. Galectin-3 and risk of cardiovascular events and all-cause mortality in type 2 diabetes[J]. Diabetes Metab Res Rev, 2019, 35(2): e3093.
[15] Arora P, Agarwal Z, Venkatraman A, et al. Galectin-3 and risk of ischaemic stroke: Reasons for Geographic and Racial Differences in Stroke cohort[J]. European Journal of Neurology, 2017, 24(12): 1464-1470.
[16] Uchino Y, Woodward AM, Mauris J, et al. Galectin-3 is an amplifier of the interleukin-1β-mediated inflammatory response in corneal keratinocytes[J]. Immunology, 2018, 154(3): 490-499.
[17] 张媚溪.Galectin-3和急性脑梗死预后的相关性分析[J].中国现代医药杂志,2019,21(9):43-46.
[18] B?fer S, Schneider D, Dewes J, et al. Molecular mechanism to recruit galectin-3 into multivesicular bodies for polarized exosomal secretion[J]. Proc Natl Acad Sci U S A, 2018, 115(19): E4396-E4405.
[19] Fukaya K, Hasegawa M, Mashitani T, et al. Oxidized galectin-1 stimulates the migration of Schwann cells from both proximal and distal stumps of transected nerves and promotes axonal regeneration after peripheral nerve injury[J]. J Neuropathol Exp Neurol, 2003, 62(2): 162-172.
[20] 王鑫红.半乳糖凝集素-1与急性脑梗死的相关性研究[J].职业技术,2021,20(2):103-108.
[21] Stoll G, Nieswandt B. Thrombo-inflammation in acute ischaemic stroke-implications for treatment[J]. Nat Rev Neurol, 2019, 15(8): 473-481.
[22] Sirko S, Irmler M, Gascón S, et al. Astrocyte reactivity after brain injury-: The role of galectins 1 and 3[J]. Glia, 2015, 63(12): 2340-2361.
[23] Sakaguchi M IY, Function of Galectin-1 in Adult Neural Stem Cells. Cell Mol[J]. Life Sci, 2007, 64(10): 1254-1258.
[24] Echigo Y, Sugiki H, Koizumi Y, et al. Activation of RAW2647 macrophages by oxidized galectin-1[J]. Immunol Lett, 2010, 131(1): 19-23.
[25] Sasaki T, Hirabayashi J, Manya H, et al. Galectin-1 induces astrocyte differentiation, which leads to production of brain-derived neurotrophic factor[J]. Glycobiology, 2004, 14(4): 357-363.

备注/Memo

备注/Memo:
基金项目:2020年济南市卫生健康委员会第二批科技计划(2020-3-58)
更新日期/Last Update: 1900-01-01