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目的初步探讨急性缺血性卒中(acute ischemic stroke,AIS)患者血浆核心蛋白聚糖(decorin,DCN)浓度的变化及其临床意义。方法采用酶联免疫吸附法(ELISA)测定102例发病在7 d内的急性缺血性卒中患者及120例体检者(对照组)血浆中DCN浓度,分析DCN在卒中亚型(TOAST法)间的浓度差异以及其对缺血性卒中的诊断价值及影响。结果急性缺血性卒中的血浆DCN浓度明显低于对照组(P<0.001),且大动脉粥样硬化性卒中组DCN浓度低于同水平各组。受试者工作特征曲线(ROC)显示DCN浓度用于诊断缺血性卒中的发生有显著意义(P<0.001),选取DCN<8 500 pg/ml作为诊断缺血性卒中的诊断界值点时,敏感度为79.4%,特异度为62.8%。Logistic回归曲线分析提示DCN<8 500 pg/ml是缺血性卒中的独立危险因素(OR=4.8;95%CI:2.1～11.1;P<0.001)。结论急性缺血性卒中患者血浆中DCN浓度显著降低,其浓度变化可以对缺血性卒中的诊断、治疗提供帮助。
Objective To investigate the changes of plasma concentration of decorin (DCN) in patients with acute ischemic stroke (AIS) and its clinical significance. Methods Plasma concentrations of DCN in 102 patients with acute ischemic stroke and 120 subjects (control group) were determined by enzyme-linked immunosorbent assay (ELISA) in the first 7 days. The concentration difference and its diagnostic value and impact on ischemic stroke. Results The concentration of plasma DCN in acute ischemic stroke was significantly lower than that in control group (P <0.001). The DCN concentration in acute atherosclerotic stroke group was lower than that in the same level. The receiver operating characteristic curve (ROC) showed that the concentration of DCN was used to diagnose the occurrence of ischemic stroke (P <0.001), and DCN <8 500 pg / ml was selected as the diagnostic threshold for diagnosis of ischemic stroke , The sensitivity was 79.4% and the specificity was 62.8%. Logistic regression analysis showed that DCN <8 500 pg / ml was an independent risk factor for ischemic stroke (OR = 4.8; 95% CI: 2.1-11.1; P <0.001). Conclusions The concentration of DCN in plasma of patients with acute ischemic stroke is significantly lower, and the change of plasma DCN concentration can help the diagnosis and treatment of ischemic stroke.