急性缺血性脑卒中患者血清糖蛋白非转移性黑色素瘤蛋白B蛋白浓度与疾病严重度及预后的相关性分析

doi:10.3969/j.issn.1006-7795.2025.04.018

首都医科大学学报 ›› 2025, Vol. 46 ›› Issue (4): 702-709.doi: 10.3969/j.issn.1006-7795.2025.04.018

急性缺血性脑卒中患者血清糖蛋白非转移性黑色素瘤蛋白B蛋白浓度与疾病严重度及预后的相关性分析

郭宇¹,陈伟观^2，3,周三连^2,3,汤莉巧¹,孙王妍¹, 张冬梅⁴,卢红建^2,3*

1.南通大学护理与康复学院南通大学第二附属医院，江苏南通 226007; 2.南通市第一人民医院康复医学科，江苏南通 226001;3.南通大学第二附属医院康复医学科，江苏南通 226001; 4.南通大学第二附属医院临床医学研究中心，江苏南通 226001

收稿日期:2024-12-13 出版日期:2025-08-21 发布日期:2025-09-01
通讯作者: 卢红建 E-mail:Dr_lhj2021@126.com
基金资助:
国家重点研发计划项目（2022YFC2405605），江苏省自然科学基金项目(BK20221274)，中国高校产学研创新基金项目（华通国康医学科研专项，2023HT042）。

Correlation between serum glycoprotein non-metastatic melanoma protein B levels and disease severity and prognosis in patients with acute ischemic stroke

Guo Yu¹, Chen Weiguan^2,3, Zhou Sanlian^2,3, Tang Liqiao¹, Sun Wangyan¹, Zhang Dongmei⁴, Lu Hongjian^2,3*

1.School of Nursing and Rehabilitation, Affiliated Hospital 2 of Nantong University,Nantong University, Nantong 226007, Jiangsu Province, China;2.Department of Rehabilitation Medicine,Nantong First People's Hospital,Nantong 226001, Jiangsu Province, China; 3.Department of Rehabilitation Medicine, Affiliated Hospital 2 of Nantong University, Nantong 226001, Jiangsu Province, China; 4.Medical Research Center, Affiliated Hospital 2 of Nantong University, Nantong 226001, Jiangsu Province, China

Received:2024-12-13 Online:2025-08-21 Published:2025-09-01
Supported by:
This study was supported by National Key Research and Development Program（2022YFC2405605），Natural Science Foundation of Jiangsu Province(BK20221274),China's University Industry Research and Innovation Fund （Huatong Guokang Medical Research Special Project 2023HT042）.

摘要/Abstract

摘要： 目的研究急性缺血性脑卒中（acute ischemic stroke，AIS）患者的血清中糖蛋白非转移性黑色素瘤蛋白B（glycoprotein non-metastatic melanoma protein B，GPNMB）浓度和神经功能损伤程度以及预后的关系，筛选潜在生物标志物，为临床诊治提供参考。方法选择2023年6月至2024年3月在南通大学第二附属医院神经内科住院治疗的105例AIS患者作为样本群。入组患者按照入院24 h美国国立卫生研究院脑卒中量表(National Institutes of Health Strobe Scale, NIHSS)评分划分为轻度组（n=42）和中重度组（n=63），以改良Rankin量表（Modified Rankin Scale, mRS）评价出院后3个月功能恢复情况，将样本细分为预后良好组（n=34）和预后不良组（n=71），采用ELISA法检测血清GPNMB蛋白浓度，分析血清GPNMB蛋白浓度与NIHSS、mRS评分的相关性，并用二元Logistic回归模型评估血清GPNMB蛋白浓度对AIS神经功能损害的预测价值和预后评估价值。结果中重度神经功能损伤及预后不良患者血清GPNMB蛋白浓度明显低于轻度及预后良好组（P<0.05），血清GPNMB蛋白浓度与NIHSS评分呈显著负相关（r=－0.196，P<0.05），与mRS评分也呈显著负相关趋势（r=－0.334，P<0.05）。多变量回归分析显示，GPNMB依然是AIS的关键独立危险因素（P<0.05），根据受试者工作特征曲线得出的评估结果表明，血清GPNMB蛋白浓度在预测神经功能损伤以及不良预后方面的有诊断价值（灵敏度达到55.6%，特异度为81.8%，准确率是63.81%，P<0.05）。结论血清GPNMB蛋白浓度降低同AIS患者神经功能损害的程度存在明显的正相关联系，很有可能会成为衡量病情严重程度和长期转归情况的重要生物指标。

关键词: 糖蛋白非转移性黑色素瘤蛋白B, 缺血性脑卒中, 神经功能缺损, 预后, 预测, 美国国立卫生研究院脑卒中量表, 改良Ranbin量表

Abstract: Objective This study mainly focuses on the relationship between the serum glycoprotein non-metastatic melanoma protein B (GPNMB) concentration and the degree of neurological damage and prognosis in patients with acute ischemic stroke (AIS), and screens potential biomarkers to provide a reference for clinical diagnosis and treatment. Methods A total of 105 AIS patients hospitalized in the Department of Neurology of the Hospital 2 of Nantong University from June 2023 to March 2024 were selected as the sample group. In this study, the patients were divided into mild group (n=42) and moderate to severe group (n=63) according to the National Institutes of Health Strobe Scale (NIHSS) score within 24 hours of admission. The Modified Rankin Scale (mRS) was used to evaluate the functional recovery 3 months after discharge. The samples were subdivided into good prognosis group (n=34) and poor prognosis group (n=71). The serum GPNMB protein level was detected by ELISA, and the correlation between serum GPNMB protein level and NIHSS and mRS scores was analyzed. The binary Logistic regression model was used to evaluate the predictive value and prognostic evaluation value of serum GPNMB protein level for AIS neurological function damage. Results The serum GPNMB protein concentration in patients with moderate to severe neurological impairment and poor prognosis was significantly lower than that in patients with mild and good prognosis (P<0.05). The serum GPNMB protein level was significantly negatively correlated with the NIHSS score (r=－0.196, P<0.05) and the mRS score (r=－0.334, P<0.05). Multivariate regression analysis showed that GPNMB was still a key independent risk factor for AIS (P<0.05). The evaluation results obtained based on the receiver operating characteristic curve (ROC) showed that the serum GPNMB protein level had diagnostic value in predicting neurological impairment and poor prognosis (sensitivity reached 55.6%, specificity was 81.8%, and the overall accuracy was 63.81%, P<0.05).Conclusion There is a significant positive correlation between the decrease in serum GPNMB protein concentration and the degree of neurological damage in AIS patients, and it is likely to become an important biological indicator for measuring the severity of the disease and long-term prognosis.

Key words: glycoprotein non-metastatic melanoma protein B, ischemic stroke, neurological deficit, prognosis, prediction, National Institutes of Health Strobe Scale, Modified Rankin Scale

中图分类号:

R743.3

郭宇, 陈伟观, 周三连, 汤莉巧, 孙王妍, 张冬梅, 卢红建. 急性缺血性脑卒中患者血清糖蛋白非转移性黑色素瘤蛋白B蛋白浓度与疾病严重度及预后的相关性分析[J]. 首都医科大学学报, 2025, 46(4): 702-709.

Guo Yu, Chen Weiguan, Zhou Sanlian, Tang Liqiao, Sun Wangyan, Zhang Dongmei, Lu Hongjian. Correlation between serum glycoprotein non-metastatic melanoma protein B levels and disease severity and prognosis in patients with acute ischemic stroke[J]. Journal of Capital Medical University, 2025, 46(4): 702-709.

参考文献

［1］GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990－2019: a systematic analysis for the global burden of disease study 2019［J］. Lancet Neurol, 2021, 20(10): 795－820.
［2］赵继宗. 我国脑心血管共患疾病现状与临床研究［J］. 首都医科大学学报, 2022, 43(5): 671－673.
［3］焦丹阳, 刘昊天, 王金麒, 等. 缺血性脑卒中治疗相关国内外研究热点与前沿分析［J］. 中华老年心脑血管病杂志, 2024, 26(9): 1110－1112.
［4］Markus H S, Leung T. Stroke in China［J］. Int J Stroke, 2023, 18(3): 256－258.
［5］Iadecola C, Anrather J. The immunology of stroke: from mechanisms to translation［J］. Nat Med, 2011, 17(7): 796－808.
［6］钟佳琪, 曹雯霏, 周慧中, 等. 急性缺血性脑卒中后自主神经功能障碍导致的多系统并发症的研究进展［J］. 上海交通大学学报(医学版), 2024, 44(7): 928－934.
［7］Anrather J, Iadecola C. Inflammation and stroke: an overview［J］. Neurotherapeutics, 2016, 13(4): 661－670.
［8］Alsbrook D L, Di Napoli M, Bhatia K, et al. Neuroinflammation in acute ischemic and hemorrhagic stroke［J］. Curr Neurol Neurosci Rep, 2023, 23(8): 407－431.
［9］Lazaratos A M, Annis M G, Siegel P G. A potent inducer of immunosuppression in cancer［J］. Oncogene, 2022, 41(41): 4573－4590.
［10］Diaz-Ortiz M E, Seo Y J, Posavi M, et al. GPNMB confers risk for Parkinson's disease through interaction with α-synuclein［J］. Science, 2022, 377(6608): eabk0637.
［11］Ping Y K, Li J Y, Xie L L, et al. GPNMB attenuates neuroinflammation and improves ischemic stroke via modulation of PI3K/Akt and p38 MAPK signaling pathways［J］. Brain Res, 2025, 1849: 149381.
［12］Nakano Y, Suzuki Y, Takagi T, et al. Glycoprotein nonmetastatic melanoma protein B (GPNMB) as a novel neuroprotective factor in cerebral ischemia-reperfusion injury［J］. Neuroscience, 2014, 277: 123－131.
［13］Khrunin A V, Khvorykh G V, Arapova A S, et al. The study of the association of polymorphisms in LSP1, GPNMB, PDPN, TAGLN, TSPO, and TUBB6 genes with the risk and outcome of ischemic stroke in the Russian population［J］. Int J Mol Sci, 2023, 24(7): 6831.
［14］中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性卒中诊治指南2023［J］. 中华神经科杂志, 2024, 57(6): 523－559.
［15］赵文博, 任长虹, 李思颉, 等. 低氧与缺血适应防治缺血性脑卒中新技术体系的创研及推广应用—2020年度国家科学技术进步奖二等奖［J］. 首都医科大学学报, 2022, 43(1): 1－5.
［16］Feske S K. Ischemic stroke［J］. Am J Med, 2021, 134(12): 1457－1464.
［17］覃心如, 邹伟, 王穆. 中国居民1990—2019年缺血性脑卒中发病和死亡趋势年龄－时期－队列分析［J］. 中国公共卫生, 2023, 39(8): 1024－1031.
［18］DeLong J H, Ohashi S N, O'connor K C. Inflammatory responses after ischemic stroke［J］. Semin Immunopathol, 2022, 44(5): 625－648.
［19］刘星雨, 卢依, 蔺冬梅, 等. 炎性标志物与缺血性脑卒中患者预后关系的研究进展［J］. 中华老年心脑血管病杂志, 2024, 26(1): 113－115.
［20］蔡俊, 辛岳, 吴秀美, 等. 急性后循环脑梗死患者疾病严重程度及预后影响因素的研究进展［J］. 中华老年心脑血管病杂志, 2020, 22(2): 222－224.
［21］Campbell B C. Hyperacute ischemic stroke care-current treatment and future directions［J］. Int J Stroke, 2024, 19(7): 718－726.
［22］王允,杨扬,方雷. 急性缺血性脑卒中患者血清CX3CL1、Trx2水平与神经功能缺损程度及认知障碍的关系［J］. 实用临床医药杂志, 2025, 29 (8): 65-69，77.
［23］刘一然,李英男,孙岩,等. 血清学指标预测急性缺血性脑卒中患者早期神经功能恶化的价值［J］. 实用临床医药杂志, 2024, 28 (13): 63-66,71.
［24］Li T, Zhang Y S, Lu Q X, et al. GPNMB ameliorates neuroinflammation via the modulation of AMPK/NFκB signaling pathway after SAH in mice［J］. J Neuroimmune Pharmacol, 2023, 18(4): 628－639.
［25］Saade M. Araujo de Souza G,Scavone C, et al. The role of GPNMB in inflammation［J］. Front Immunol, 2021, 12: 674739.
［26］Neal M L, Boyle A M, Budge K M, et al. The glycoprotein GPNMB attenuates astrocyte inflammatory responses through the CD44 receptor［J］. J Neuroinflammation, 2018, 15(1): 73.
［27］刘梦, 朱洋洋, 方敬献. GPNMB通过PI3K/Akt通路调节小胶质细胞M2极化减轻缺血性脑卒中后神经损伤的机制研究［J］. 中国免疫学杂志, 2023, 39(12): 2483－2488.

[1]	毛文苹, 韩倩, 焦风伟, 王晶, 黄克武. 不同炎性反应标志物预测慢性阻塞性肺疾病病情加重患者预后的比较[J]. 首都医科大学学报, 2025, 46(4): 718-723.
[2]	李茜, 朱红, 叶梦, 吴研哲, 吴利, 麻微微. 相位角与中老年2型糖尿病患者肌少症的相关性研究[J]. 首都医科大学学报, 2025, 46(2): 340-347.
[3]	简焕玲, 戴梓, 岑肖丽, 陈慧玲, 刘志文, 赵颖. 血清尿酸与高密度脂蛋白胆固醇比值与女性不孕的关系[J]. 首都医科大学学报, 2025, 46(2): 348-355.
[4]	顾超雄, 李明. 不忘初心，砥砺前行，做科研先锋——中国工程院院士吉训明教授[J]. 首都医科大学学报, 2024, 45(3): 375-378.

急性缺血性脑卒中患者血清糖蛋白非转移性黑色素瘤蛋白B蛋白浓度与疾病严重度及预后的相关性分析

Correlation between serum glycoprotein non-metastatic melanoma protein B levels and disease severity and prognosis in patients with acute ischemic stroke

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 4

编辑推荐

Metrics

本文评价