摘要
目的分析血清铁调素(Hepc)、血清铁蛋白(SF)与颅脑损伤患者去骨瓣减压术后脑水肿发生的关系,并探究其对脑水肿发生的预测价值。方法抽取2020年6月至2022年6月河南科技大学第二附属医院神经外科行去骨瓣减压术治疗的118例颅脑损伤患者,观察患者术后7 d内脑水肿的发生情况,根据脑水肿的发生情况将患者分为发生组与未发生组。设计一般资料收集表,填写并记录患者的临床资料与实验室指标,并检测患者术前Hepc与SF水平;分析Hepc和SF水平与患者术后脑水肿发生的关系,同时绘制受试者工作特征(ROC)曲线,探究血清Hepc、SF水平对颅脑损伤患者去骨瓣减压术后脑水肿发生的预测作用。结果去骨瓣减压术后7 d内,118例颅脑损伤患者中脑水肿发生率为28.81%,未发生占比71.19%;两组脑出血量、纤维蛋白原(Fib)水平比较,差异有统计学意义(P<0.05);两组其他资料比较,差异无统计学意义(P>0.05);发生组血清Hepc、SF水平均高于未发生组,差异有统计学意义(P<0.05);经点二列相关性分析,血清Hepc和SF水平与患者术后脑水肿发生呈正相关(r>0,P<0.05);绘制ROC曲线,结果显示,血清Hepc和SF水平单独及联合预测颅脑损伤患者去骨瓣减压术后脑水肿的曲线下面积(AUC)>0.7,均具有一定的价值,且二者联合预测的价值更高。结论血清Hepc、SF水平在颅脑损伤患者去骨瓣减压术后脑水肿的发生情况中具有重要的预测价值。
Objective To analyze the relationship between serum hepcidin(Hepc),serum ferritin(SF)and brain edema after decompressive craniectomy in patients with brain injury,and explore its predictive value for brain edema.Methods From June 2020 to June 2022,118 patients with brain injury who underwent decompressive craniectomy in the Department of Neurosurgery of the Second Affiliated Hospital of Henan University of Science and Technology were selected to observe the occurrence of brain edema within 7 days after surgery.According to the occurrence of brain edema,the patients were divided into occurrence group and non-occurrence group.The general data collection table was designed,the clinical data and laboratory indexes of the patients were filled in and recorded,and the preoperative Hepc and SF levels were detected.The relationship between the levels of Hepc and SF and the occurrence of postoperative cerebral edema were analyzed,and the receiver operating characteristic(ROC)curve was drawn to explore the predictive effect of serum Hepc and SF levels on the occurrence of cerebral edema after decompressive craniectomy in patients with craniocerebral injury.Results Within 7 days after decompressive craniectomy,the incidence of brain edema in 118 patients with brain injury was 28.81%,and the rate of non-occurrence was 71.19%.There were statistical differences in cerebral hemorrhage volume and fibrinogen(Fib)level between the two groups(P<0.05).There was no statistical difference between the two groups in other data(P>0.05).The levels of serum Hepc and SF in the occurrence group were higher than those in the non-occurrence group(P<0.05).Correlation analysis showed that serum Hepc and SF levels were positively correlated with postoperative cerebral edema(r>0,P<0.05).The ROC curve was drawn,and the results showed that the area under the curve(AUC)of serum Hepc and SF levels alone and in combination to predict brain edema after decompressive craniectomy in patients with brain injury were more than 0.7,which had certain value,and the combined prediction value of the two was higher.Conclusion Serum Hepc and SF levels have important predictive value in the occurrence of brain edema in patients with brain injury after decompressive craniectomy.
作者
徐文中
XU Wenzhong(Department of Neurosurgery,the Second Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)
出处
《河南医学研究》
2023年第24期4495-4498,共4页
Henan Medical Research
