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第45卷第8期       孙王妍,陈伟观,周三连,等. 血清PDCD4水平对急性缺血性脑卒中患者神经功能缺损和预后的
                  2025年8月               预测价值[J]. 南京医科大学学报(自然科学版),2025,45(8):1140-1147                   ·1145 ·


                A                  B                         C                 D
                     20    ***                      r=0.55       20    ***                     mRS score
                                      50            P < 0.001                                                5.00
                    (ng/mL)  15      NIHSS  40                  (ng/mL)  15      Low PDCD4                   4.00
                                                                                                             3.00
                                                                 10
                                      30
                     10
                                                                                                             2.00
                    PDCD4  5 0        20                        PDCD4  5 0       High PDCD4                  1.00
                                                                                                             0.00
                                      10
                                      0                                                  0   20  40   60  80
                     -5  Mild           0   PDCD4(ng/mL)  15     -5                           Patients(%)
                                                    10
                                              5
                      Moderate to severe                        Good prognosis
                                                                    Poor prognosis
                      E                 r=0.42     F                 r=0.24     G                 r=0.30
                          30                          200                           1.5
                                        P < 0.001                    P=0.016                      P=0.003
                          20                          (mg/L)  150                  (ng/mL)  1.0
                         NLR                          100
                          10                          Hs⁃CRP  50                   PCT  0.5
                          0                             0                           0.0
                            0     5     10    15         0     5     10    15         0     5     10    15
                                PDCD4(ng/mL)                  PDCD4(ng/mL)                PDCD4(ng/mL)
                   A:Comparison of serum PDCD4 levels between patients with mild and moderate⁃to⁃severe neurological impairment in acute ischemic stroke(AIS)
               (P < 0.001). B:Scatter plot showing the correlation between serum PDCD4 levels and NIHSS scores in AIS patients. C:Comparison of serum PDCD4
                levels between AIS patients with good and poor prognosis(P < 0.001). D:Distribution of modified Rankin Scale(mRS)scores in AIS patients stratified
                by high and low PDCD4 levels. E:Correlation between serum PDCD4 levels andneutrophil⁃to⁃lymphocyte ratio(NLR)in AIS patients.F:Correlation be⁃
                tween serum PDCD4 levels and high⁃sensitivity C⁃reactive protein(Hs⁃CRP).G:Correlation between serum PDCD4 levels and procalcitonin(PCT).
                                           图1 血清PDCD4蛋白水平与炎症指标的相关性分析
                            Figure 1 Correlation analysis between serum PDCD4 concentration and inflammatory markers

                                        表3 急性缺血性卒中患者神经功能缺损的Logistic回归分析
                                   Table 3 Logistic regression analyses of neurological deficits in AIS patients
                     Variable         Crude model OR(95%CI)       P         Adjusted model OR(95%CI)       P
                  Age                    1.05(1.01-1.10)0        0.024           1.04(0.96-1.12)          0.336
                  Atrial fibrillation    2.92(1.13-7.54)0        0.026           1.16(0.22-6.15)          0.864
                  NLR                    1.50(1.25-1.80)0        0.001           1.41(1.14-1.73)          0.001
                  Hs⁃CRP                 1.03(1.01-1.05)0        0.004           1.01(0.99-1.03)          0.384
                  PCT                    4.36(0.76-24.98)        0.098           0.99(0.71-1.39)          0.956
                  PDCD4                  2.01(1.48-2.80)0        0.001           1.95(1.22-3.13)          0.002

                                            表4 急性缺血性卒中患者预后的Logistic回归分析
                                       Table 4 Logistic regression analyses of prognosis in AIS patients
                   Variable         Crude model OR(95%CI)       P          Adjusted model OR(95%CI)      P
                Atrial fibrillation    2.72(1.06-7.00)         0.037          1.87(0.34-10.43)         0.474
                NLR                    1.45(1.23-1.72)         0.001          1.33(1.11-1.60)          0.003
                Hs⁃CRP                 1.03(1.01-1.04)         0.006          1.00(0.98-1.03)          0.438
                PCT                    4.09(0.72-23.24)        0.112          1.04(0.49-2.20)          0.923
                FDP                    1.13(1.06-1.21)         0.006          1.09(0.99-1.19)          0.068
                PDCD4                  1.72(1.30-2.27)         0.001          1.61(1.11-2.30)          0.013


                但不同的是,本研究关注的是 AIS 患者血清 PDCD4                      患者认知功能障碍的重要标志物。
                水平与炎症指标的相关性,PDCD4与炎症指标呈现                              本研究有一定的局限性:①这是一项单中心观
                正相关。结合上述文献报道,PDCD4水平不仅可能                          察性队列研究,样本量较小,纳入的临床变量有

                是预测AIS患者发生神经炎症的重要指标,也是AIS                         限。尽管我们设置了较为严格的纳入与排除标准
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