血清CCL21、NLRP3与脑梗死患者机械取栓术后出血转化的相关性研究
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中图分类号：R743.33 文献标志码：A DOI：10.11958/20250110
血清CCL21、NLRP3与脑梗死患者机械取栓术后出血转化的相关性研究
Correlation of serum CCL21 and NLRP3 with hemorrhagic conversion after mechanical thrombectomyin patientswith cerebral infarction
JIA Wenxin， ZHOU Lijuan， WANG Lixiang DepartmentofNeurology，theEighthPeople'sHospital ofJinan，Jinan2711O4，China
Abstract：ObjectiveTo explore the correlation between serum chemokine C-C ligand21（CCL21），NOD like receptor protein 3（NLRP3）and hemorrhagic transformation （HT）after mechanicalthrombectomy in patientswith acute cerebral infarction（ACI）.MethodsAtotal of210ACI patientswhounderwent mechanicalthrombectomywereselected anddivided into the HT group （19 cases）andthenon HTgroup （191cases）basedon there-examinationof head CT 24- hours after treatment.The diferences in clinical data and serum levels of CCL21 and NLRP3 werecompared between two groups.Multivariate Logisticregressionanalysis was used toanalyze the influencing factors of HToccurence.Receiver operating characteristic （ROC）curve was used toanalyze the predictive valueof serum CCL21and NLRP3 for HT.Results Theproportionofatrialfibrillation，anteriorcirculation infarctionandpreoperativeNational InstitutesofHealth StrokeScale （NIHSS） scores were higher in the HT group than those in the non HT group （ P<0.05 ）. The preoperative serum levels of CCL21 and NLRP3were higherin theHT group than thosein the nonHT group（ P<0.05 ）.The Logistic regression model analysis resultsshowed thatatrialfibrilltion，anteriorcirculation infarction，preoperative NHSS score，CCL21andNRP3 were risk factors for postoperative HT in ACI patients （ P<0.05 ）.The application of receiver operating characteristic （ROC） curve analysisresultsshowed thattheareaunder thecurve （AUC）forpredicting HToccurrenceby CCL21 was 0.850 （95%CI： 0.763-0.936）.TheAUC predicted byNLRP3 was 0.787（95%CI： 0.703-0.871），and thecombined detectionof the two further improved the predictive value （AUC=0.921，95%CI： 0.867-0.976）.ConclusionCCL21and NLRP3are closely related totheoccurrenceofHTinACIpatientsaftermechanicalthrombectomy，andwhichareinfluencingfactors forthe occurrence of HT after mechanical thrombectomy.
Key Words：acutecerebral infarction; hemorhagic transformation;chemokine C-C motif ligand 21; NOD like receptor protein3;mechanical thrombectomy
急性脑梗死（acutecerebral infarct，ACI）是由于脑血管的阻塞导致脑组织供血不足，进而引起脑细胞损伤或死亡的一种急性脑血管病变。（剩余9717字）