李东凤

【摘要】 目的：研究血清髓鞘堿性蛋白（MBP）、网膜素-1（Omentin-1）与急性脑梗死（ACI）患者病情的关系及对预后的预测价值。方法：选取2018年1月-2020年1月本院收治的113例ACI患者作为观察组，另选取30例健康志愿者作为对照组。比较两组血清MBP及Omentin-1水平;比较观察组中不同脑梗死面积及神经功能损伤严重程度者的血清MBP及Omentin-1水平。观察组出院后随访3个月，评估mRS评分，比较预后良好者（mRS≤2分）与预后不良者（mRS>2分）入院时MBP及Omentin-1水平，并绘制ROC曲线，分析其对ACI患者预后的预测价值。结果：观察组血清MBP水平高于对照组，Omentin-1水平低于对照组（P<0.05）。观察组中不同脑梗死面积者血清MBP及Omentin-1水平比较，差异均有统计学意义（P<0.05）;间隙性、小面积、中面积及大面积脑梗死患者血清MBP呈上升趋势，血清Omentin-1呈下降趋势（P<0.05）。观察组中不同神经功能损伤严重程度者血清MBP及Omentin-1水平比较，差异均有统计学意义（P<0.05）;轻度、中度、重度患者血清MBP水平呈上升趋势，血清Omentin-1水平呈下降趋势（P<0.05）。113例ACI患者中预后良好者共88例，预后不良者共25例。预后良好者入院时血清MBP低于预后不良者，Omentin-1水平高于预后不良者（P<0.05）。血清MBP、Omentin-1及联合检测对ACI患者预后情况均具有良好的预测效能，其中联合检测预测效能最高[AUC=0.849，95%CI（0.742，0.955）]。结论：ACI患者血清MBP及Omentin-1水平均异常，血清MBP及Omentin-1可有效反映患者脑梗死面积及神经功能损伤严重程度，且在预测患者预后中具有良好价值。

【关键词】 急性脑梗死 MBP Omentin-1

[Abstract] Objective： To investigate the relationship between serum myelin basic protein （MBP）， Omentin-1 and the condition of patients with acute cerebral infarction （ACI） and their predictive value for prognosis. Method： A total of 113 ACI patients admitted to our hospital from January 2018 to January 2020 were selected as the observation group， and another 30 healthy volunteers were selected as the control group. Serum MBP and Omentin-1 levels were compared between the two groups. The levels of serum MBP and Omentin-1 in patients with different cerebral infarction area and severity of neurological impairment in the observation group were compared. The observation group was followed up for 3 months after discharge， and the mRS score was evaluated， the levels of MBP and Omentin-1 at admission were compared between patients with good prognosis （mRS≤2 points） and patients with poor prognosis （mRS>2 points）， and the ROC curve was plotted to analyze their predictive value for the prognosis of ACI patients. Result： The level of serum MBP in the observation group was higher than that in the control group， and the level of Omentin-1 in the observation group was lower than that in the control group （P<0.05）. There were statistically significant differences in serum MBP and Omentin-1 levels among patients with different cerebral infarction areas in the observation group （P<0.05）. The serum MBP was increased and the serum Omentin-1 was decreased in patients with interstitial， small area， medium area and large area cerebral infarction （P<0.05）. There were statistically significant differences in the levels of serum MBP and Omentin-1 among patients with different severity of neurological impairment in the observation group （P<0.05）. In mild， moderate and severe patients， the serum MBP level was increased， and the serum Omentin-1 level was decreased （P<0.05）. Among 113 ACI patients， 88 patients had good prognosis and 25 patients had poor prognosis. The level of serum MBP in patients with good prognosis was lower than that in patients with poor prognosis， and the level of Omentin-1 was higher than that in patients with poor prognosis （P<0.05）. Serum MBP， Omentin-1 and combined detection had good predictive efficacy for the prognosis of ACI patients， among which combined detection had the highest predictive efficacy [（AUC=0.849， 95%CI（0.742， 0.955）]. Conclusion： The levels of serum MBP and Omentin-1 are abnormal in patients with ACI. Serum MBP and Omentin-1 can effectively reflect the area of cerebral infarction and the severity of neurological impairment， and have good value in predicting the prognosis of patients.

[Key words] Acute cerebral infarction MBP Omentin-1

First-author’s address： Jingmen City Duodao People’s Hospital， Jingmen 448000， China

doi：10.3969/j.issn.1674-4985.2021.25.006

急性脑梗死（acute cerebral infarction，ACI）是临床上发病率最高的脑血管性疾病，目前，关于ACI病情评估及神经损伤判断的方式较多，但并无统一标准[1]。髓鞘碱性蛋白（myelin basic protein，MBP）是一种神经特异性物质，一般情况下血清含量很低，但当脑组织受损后，MBP会释放至外周血中，导致血清MBP水平上升[2]。……