关键词: 脑梗死, 预后, 神经钙蛋白, 趋化因子CXCL16, 抗心磷脂抗体, 诊断

Abstract: Background　Acute cerebral infarction is a common clinical cerebrovascular disease that seriously threatens human life. Studies have shown serum test indicators have good accuracy in assessing brain injury，but it is necessary to find indicators with higher specificity and accuracy，providing insights into the prediction of the progression and prognosis of acute cerebral infarction. Objective　To explore the relationship of serum levels of visinin-like protein-1（VILIP-1），CXC chemokine ligand 16（CXCL16） and anticardiolipin antibody （ACA） levels with the severity and prognosis in patients with acute cerebral infarction.Methods　Patients with acute cerebral infarction （n=116） and healthy examinees （n=60） were selected from the First People's Hospital of Fuyang District，Hangzhou from June 2019 to August 2020. Serum levels of VILIP-1，CXCL16 and ACA were compared between acute cerebral infarction patients and healthy examinees，and between subgroups of acute cerebral infarction patients divided by degree of neurological impairment〔mild subgroup （n=36），moderate subgroup（n=48） and severe subgroup（n=32）〕，head CT-detected infarction size 〔small infarction subgroup（n=31），medium infarction subgroup （n=55），and large infarction subgroup （n=30）〕，and prognosis assessed by the modified Rankin Scale〔good prognosis subgroup（n=70），poor prognosis subgroup（n=46）〕. The ROC curve of the serum VILIP-1，CXCL16 and ACA was plotted to examine the prognostic value of each of them for acute cerebral infarction. Results　Acute cerebral infarction patients had significantly higher levels of VILIP-1，CXCL16 and ACA than the healthy examinees （P<0.05）. The levels of VILIP-1，CXCL16 and ACA showed a significant increase successively across mild，moderate and severe subgroups （P<0.05）. The level of these three parameters also demonstrated a notable increase successively across small，intermediate and large infarction subgroups （P<0.05）. Furthermore，they were much higher in poor prognosis subgroup than those in good prognosis subgroup （P<0.05）. The AUC of serum VILIP-1 for predicting the prognosis of acute cerebral infarction was 0.848，with 82.61% sensitivity，and 75.71% specificity.The AUC of serum CXCL16 was 0.820，with 89.13% sensitivity，and 64.29% specificity.The AUC of serum ACA was 0.784，with 73.91% sensitivity，and 71.43% specificity. Conclusion　Elevated VILIP-1，CXCL16 and ACA were found in patients with acute cerebral infarction，whose expression levels were closely related to the degree of cerebral infarction and clinical prognosis，so they may be used as prognostic indicators for acute cerebral infarction.

Key words: Brain infarction, Prognosis, Neurocalcin, Chemokine CXCL16, Anticardiolipin antibody, Diagnosis