徐耀平

[摘要] 目的 探討首发性缺血性脑卒中患者血清内S100钙结合蛋白B（S100B）与胶质纤维酸性蛋白（GFAP）、转化生长因子β1（TGF-β1）相关性及对预后的影响。方法 选取2018年1月至2019年1月于我院诊断为缺血性脑卒中的符合标准的47例患者作为观察组，50名健康人员作为对照组，比较两组血清中S100B蛋白、GFAP、TGF-β1的相对表达量，分析观察组三个指标与NIHSS评分的相关性，推算出三者预测脑卒中的概率，最后分析三者对首发性缺血性脑卒中患者预后的影响。结果 观察组S100B蛋白、GFAP的相对表达量高于对照组，TGF-β1低于对照组，S100B蛋白、GFAP与NIHSS评分呈正相关（P<0.05），而TGF-β1与NIHSS评分呈负相关（P<0.05），S100B蛋白、GFAP、TGF-β1对首发性缺血性脑卒中的预测价值一般，而三者联合检测有较好的预测价值，S100B蛋白、GFAP与Barthel呈负相关（P<0.05），而TGF-β1呈正相关（P<0.05）。结论 S100B蛋白、GFAP、TGF-β1与首发性缺血性脑卒中密切相关，并具有一定的预测价值，值得在临床上大力推广。

[关键词] 首发性缺血性脑卒中;S100B蛋白;GFAP;TGF-β1;相关性;预后

[中图分类号] R743.33          [文献标识码] B          [文章编号] 1673-9701（2021）32-0055-04

[Abstract] Objective To explore the correlation between serum S100 calcium binding protein B（S100B）， glial fibrillary acidic protein（GFAP）， and transforming growth factor β1（TGF-β1） in the patients with first episode ischemic stroke and their influence on prognosis. Methods A total of 47 patients who met the criteria and were diagnosed with ischemic stroke in our hospital from January 2018 to January 2019 were selected as the observation group. A total of 50 healthy people were selected as the control group. The relative expression levels of serum S100B protein， GFAP， and TGF-β1 were compared between the two groups. The correlation between the three indicators in the observation group and the NIHSS score was analyzed. The probability of the three indicators in the prediction of stroke was calculated. Finally， the influence of the three indicators on the prognosis of patients with first episode ischemic stroke was analyzed. Results The relative expression of S100B protein and GFAP in the observation group was higher than that in the control group， and TGF-β1 was lower than that in the control group. S100B protein and GFAP were positively correlated with the NIHSS score， and TGF-β1 was negatively correlated with NIHSS score. The predictive value of S100B protein， GFAP， and TGF-β1 for the first episode ischemic stroke was not high， but the combined detection of the three indicators showed a better predictive value. S100B protein and GFAP were negatively correlated with the Barthel index，while TGF-β1 was positively correlated with Barthel index（P<0.05）. Conclusion S100B protein， GFAP， TGF-β1 are closely related to first episode ischemic stroke， and have a certain predictive value， which are worthy of widespread clinical promotion.

[Key words] First episode ischemic stroke; S100B protein; GFAP; TGF-β1; Correlation; Prognosis

脑卒中（Cerebral stroke）是神经内科常见的一种疾病，目前最常见的诊断方法为血管造影[1]。但基层医院难以开展此类检查，因此寻找快速的诊断方法至关重要。S100钙结合蛋白B（S100 calcium binding peotein B，S100B）是一类钙结合蛋白，在细胞增殖与分化、细胞信号传导等方面具有重要作用[2]。研究发现，S100B蛋白与脑卒中的发病有关[3]。胶质纤维酸性蛋白（Glial fibrillary acidic protein，GFAP）是星形胶质细胞的一种标记蛋白[4]。发生脑卒中时，星形胶质细胞增殖程度增高，GFAP相应升高[5]。转化生长因子β1（Transform growth factor β1，TGF-β1）是一种多潜能细胞因子，可参与血管平滑肌的增殖及血管重塑的过程，因此TGF-β1与脑血管疾病具有一定的相关性。……