目的：探讨血浆水通道蛋白4（AQP4）水平能否作为预测恶性大脑中动脉梗死（mMCAI）的生化指标之一。方法：选择我院2015年7月至2017年12月间收治的66例发病48 h内出现前循环区脑梗死的患者，其中34例mMCAI患者设为mMCAI组，32例非mMCAI患者设为非mMCAI组。对两组患者血浆AQP4、血糖、血生化、血脂、纤维蛋白原水平及NIHSS量表评估的神经功能缺损程度进行比较，分析血浆AQP4水平与其他指标的相关性及影响因素。结果：mMCAI组的糖化血红蛋白水平较非mMCAI组明显增高（P<0.05）。方差分析显示，NIHSS量表评分mMCAI组具有显著的主效应（F=4.008，P=0.046），血浆AQP4水平mMCAI组也具有显著的主效应（F=4.831，P=0.029）；进一步Post-hoc分析显示，与非mMCAI组相比，mMCAI组血浆AQP4水平显著增高。在mMCAI组，糖化血红蛋白及低密度脂蛋白胆固醇与血浆AQP4水平有显著的相关性（分别r=0.424，P=0.034；r=-0.390，P=0.047）。结论：mMCAI患者的血浆AQP4水平显著升高，糖化血红蛋白与血浆AQP4水平正相关，低密度脂蛋白胆固醇与血浆AQP4水平负相关。

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