摘要
目的:探讨高血压基底节区脑出血(HBGH)患者血清CXC趋化因子配体1(CXCL1)、CXC趋化因子配体10(CXCL10)与神经损伤指标和微创穿刺引流术后预后的关系。方法:选取2020年2月~2023年4月聊城市人民医院东院区收治的行微创穿刺引流术治疗的HBGH患者162例纳入研究组,选取体检健康的志愿者110例纳入对照组。检测对比两组血清CXCL1、CXCL10和神经损伤指标[神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、S100β蛋白]水平。采用Pearson检验分析血清CXCL1、CXCL10与神经损伤指标的相关性。所有患者均随访3个月,根据改良Rankin量表(mRS)评分分为预后良好组和预后不良组。采用多因素Logistic回归模型分析HBGH患者微创穿刺引流术后预后的影响因素。结果:研究组的血清CXCL1、CXCL10水平高于对照组(P<0.05)。研究组的血清NSE、GFAP、S100β蛋白水平高于对照组(P<0.05)。Pearson检验分析结果显示,血清CXCL1、CXCL10与NSE、GFAP、S100β蛋白均呈正相关(P<0.05)。单因素分析结果显示,预后不良与年龄、甘油三酯(TG)、低密度脂蛋白(LDL)、凝血酶原时间(PT)、C反应蛋白(CRP)、血肿破入脑室、血肿体积、术后24 h内血肿清除率、尿激酶冲管次数、术后颅内出血再发、CXCL1、CXCL10有关(P<0.05)。多因素Logistic回归分析结果显示,年龄偏大、LDL偏高、血肿体积偏大、术后24 h内血肿清除率偏低、尿激酶冲管次数偏多、CXCL1偏高、CXCL10偏高是HBGH患者微创穿刺引流术后预后不良的危险因素(P<0.05)。结论:HBGH患者血清CXCL1、CXCL10水平升高可能导致神经损伤和不良预后。年龄、LDL、血肿体积、术后24 h内血肿清除率、尿激酶冲管次数、CXCL1、CXCL10是HBGH患者术后预后不良的危险因素,值得引起重视。
Objective:To investigate the relationship between serum CXC chemokine ligand 1(CXCL1),CXC chemokine ligand 10(CXCL10)and nerve injury index and prognosis after minimally invasive puncture and drainage in patients with hypertensive basal ganglia hemorrhage(HBGH).Methods:162 patients with HBGH who were underwent minimally invasive puncture and drainage in the East ward of Liaocheng People's Hospital from February 2020 to April 2023 were selected as study group,and 110 healthy volunteers who were underwent physical examination in our hospital during the same period were selected as control group.The levels of serum CXCL1,CXCL10 and nerve injury indexes[neuron-specific enolase(NSE),glial fibrillary acidic protein(GFAP)and S100βprotein]were detected and compared between two groups.The correlation between serum CXCL1,CXCL10 and nerve injury indexes were analyzed by Pearson test.All patients were followed up for 3 months,and the prognosis of the patients was evaluated according to the modified Rankin scale(mRS),patients were divided into good prognosis group and poor prognosis group.The prognostic factors of patients with HBGH after minimally invasive puncture and drainage was analyzed by multivariate Logistic regression model.Results:The levels of serum CXCL1 and CXCL10 in study group were higher than those in control group(P<0.05).The levels of serum NSE,GFAP and S100βprotein in study group were higher than those in control group(P<0.05).Pearson test analysis showed that,serum CXCL1 and CXCL10 were positively correlated with NSE,GFAP and S100βprotein(P<0.05).Univariate analysis showed that,poor prognosis was associated with age,triglyceride(TG),low-density lipoprotein(LDL),prothrombin time(PT),C-reactive protein(CRP),hematoma breaking into the ventricle,hematoma volume,hematoma clearance rate within 24 hours after operation,number of urokinase flushing,recurrence of postoperative intracranial hemorrhage,CXCL1 and CXCL10(P<0.05).Multivariate Logistic regression analysis showed that,older age,higher LDL,larger hematoma volume,lower hematoma clearance rate within 24 hours after operation,more times of urokinase flushing,higher CXCL1 and higher CXCL10 were risk factors for poor prognosis of HBGH patients after minimally invasive puncture and drainage(P<0.05).Conclusion:Elevate serum CXCL1 and CXCL10 levels in patients with HBGH may lead to nerve injury and poor prognosis.Age,LDL,hematoma volume,hematoma clearance rate within 24 hours after operation,number of urokinase flushes,CXCL1 and CXCL10 are risk factors for poor prognosis in patients with HBGH,which deserves attention.
作者
汤冉冉
王鑫
张树葆
罗坤
郭运发
TANG Ran-ran;WANG Xin;ZHANG Shu-bao;LUO Kun;GUO Yun-fa(Department of Neurosurgery,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830000,China;Department of Intensive Care Medicine,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830000,China;Department of Neurosurgery,East ward of Liaocheng People's Hospital,Liaocheng,Shandong,252000,China)
出处
《现代生物医学进展》
CAS
2023年第24期4791-4795,4800,共6页
Progress in Modern Biomedicine
基金
新疆维吾尔自治区自然科学基金项目(2022D01C479)。
关键词
高血压脑出血
CXCL1、CXCL10
神经损伤
微创穿刺引流术
预后
Hypertensive basal ganglia hemorrhage
CXCL1
CXCL10
Nerve injury
Minimally invasive puncture and drainage surgery
Prognosis
