血清骨桥蛋白水平在急性脑出血患者诊断及预后评价中的价值

发布时间：2018-04-17 04:07

本文选题：骨桥蛋白质 + 脑出血　；参考：《重庆医学》2017年34期

【摘要】：目的通过分析血清骨桥蛋白(OPN)水平在急性脑出血患者的变化及对预后的影响,探讨OPN在急性脑出血的临床价值。方法选取2014年1月至2016年12月就诊于该院的急性脑出血患者63例作为急性脑出血组,来该院健康体检者60例作为对照组。收集入组者的相关临床资料,包含吸烟史、血脂、糖尿病、血压、体温、白细胞数、纤维蛋白原等,入院24h内对脑出血组患者完成脑出血评分,并评定组内患者神经功能缺损严重程度,根据入院时CT影像计算出血量。利用改良Rankin量表(mRS)评分评估脑出血3个月后的预后情况。结果急性脑出血组血清骨桥蛋白[(7.81±4.97)ng/mL]水平明显高于对照组[(5.41±3.25)ng/mL]水平(P=0.008)。急性脑出血组中预后良好(mRS评分小于4分)37例(58.73%),预后不良(mRS评分大于或等于4分)26例(41.27%)。预后不良组其白细胞数量、出血体积、脑出血评分、脑出血破入脑室比例及OPN水平均明显高于预后良好组(均P0.05)。通过绘制受试者工作曲线(ROC),得到当OPN的截断点为7.38ng/mL时,曲线下面积为0.652,敏感度为0.691,特异度为0.627。进行多因素Logistic回归分析显示,血清OPN水平大于7.38ng/mL(OR=3.916,95%CI:1.023~15.104,P=0.031)及脑出血破入脑室(OR=5.635,95%CI:1.016~26.305,P=0.030)是脑出血预后不良的独立危险因素。结论 OPN水平升高,是急性脑出血患者预后不良的独立危险因素,可作为评价脑出血患者预后的参考生物学指标。
[Abstract]:Objective to investigate the clinical value of OPN in acute intracerebral hemorrhage by analyzing the changes of serum osteopontin (OPN) level in patients with acute intracerebral hemorrhage (AICH) and its influence on prognosis.Methods from January 2014 to December 2016, 63 patients with acute cerebral hemorrhage were selected as acute cerebral hemorrhage group and 60 healthy persons as control group.Relevant clinical data were collected, including smoking history, blood lipid, diabetes, blood pressure, body temperature, white blood cell count, fibrinogen, etc.The severity of neurological impairment in the group was evaluated and the amount of blood loss was calculated according to CT images at admission.The prognosis of intracerebral hemorrhage (ICH) was evaluated by modified Rankin scale (mRS) after 3 months.Results the serum level of osteopontin [7.81 卤4.97)ng/mL] in acute cerebral hemorrhage group was significantly higher than that in control group [5.41 卤3.25)ng/mL].In the acute intracerebral hemorrhage group, 37 cases had a good prognosis less than 4 minutes and 37 cases had a good prognosis. 26 cases with poor prognosis score were greater than or equal to 4 scores or 41.27%.The white blood cell count, hemorrhage volume, cerebral hemorrhage score, the proportion of intracerebral hemorrhage breaking into the ventricle and the level of OPN in the poor prognosis group were significantly higher than those in the good prognosis group (all P 0.05).When the cut-off point of OPN is 7.38ng/mL, the area under the curve is 0.652, the sensitivity is 0.691, and the specificity is 0.627.Multivariate Logistic regression analysis showed that the serum OPN level greater than 7.38 ng / mLL was 3.91695% CI: 1.023 + 15.104% P0. 031) and intracerebral hemorrhage ruptured into the ventricle. The risk factors of poor prognosis of ICH were as follows: ICH: 1.016% 26.305% P0.030).Conclusion elevated OPN level is an independent risk factor for poor prognosis in patients with acute intracerebral hemorrhage. It can be used as a reference biological index to evaluate the prognosis of patients with acute cerebral hemorrhage.
【作者单位】：广东省人民医院神经内科/广东省医学科学院/广东省老年医学研究所/广东省神经科学研究所;
【分类号】：R743.34

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