血浆脂联素水平预测脑出血患者早期病死率的价值  

Value of plasma adiponectin in predicting early mortality of patients with acute intracerebral hemorrhage

作　　者：王文宏[1] 王宏[1] 游洋[1] 俞文华[2] 董晓巧[2] 车志豪[2] 

机构地区：[1]东南大学医学院附属中大医院神经外科,江苏省210009 [2]杭州市第一人民医院神经外科

出　　处：《江苏医药》2012年第16期1890-1892,共3页Jiangsu Medical Journal

基　　金：江苏省自然基金资助项目(BK2010419)

摘　　要：目的探讨脑出血患者血浆中脂联素浓度预测脑损害严重程度及早期病死率的意义。方法选择86例脑出血患者及30例对照组。用酶联免疫法分别检测其入院后第1、2、3、5及7天的血浆脂联素浓度,分析血浆脂联素水平与脑出血患者脑损害程度之间的关系。结果脑出血患者血浆脂联素浓度6h内明显升高,24h达高峰,持续2d后逐渐下降;其浓度7d内都明显高于对照组。多元相关分析显示,血浆脂联素水平可独立预测1周内脑出血患者病死率(OR=1.199,95%IC=1.035-1.389,P<0.05),并与患者入院时格拉斯哥昏迷(GCS)评分及血浆C反应蛋白水平密切相关(P<0.01)。血浆脂联素>16.4μg/ml预测患者1周病死率的敏感性为65.6%,特异性为90.7%。血浆脂联素浓度的预测价值低于GCS评分(P<0.01)及血肿量的体积(P<0.05)。结论脂联素可作为一种对脑出血早期病死率的独立预测因素。Objective To investigate the value of plasma adiponectin in predicting the severity of brain injury and early mortality of the patients with acute intracerebral hemorrhage（ICH）.MethodsPlasma adiponectin was measured by ELISA at admission and on the 1st,2nd,3rd,5th,and 7th day after ICH in 86 patientswith acute ICH（group A） and 30 controls（group B）.Correlation of plasma adiponectin level and the severity of brain injury was analyzed.Results After ICH,plasma adiponectin level in group A increased immediately within 6 h,peaked within 24 h,plateaued in 2 days,and decreased gradually thereafter,which was higher than that in group B in 7 days.Plasma adiponectin level was an independent predictor for 1-week mortality（OR=1.199,95% CI=1.035-1.389,P〈0.05）,which was closely associated with Glasgow coma scale（GCS） score and plasma C-reactive protein level（P〈0.01）.The sensitivity and specificity of plasma adiponectin level of 〉16.4 μg/ml were 65.6% and 90.7%,respectively,in predicting the 1-week mortality of ICH patients.The predictive value of plasma adiponectin concentration was lower than that of GCS score（P〈0.01） or hematoma volume（P〈0.05）.Conclusion Plasma adiponectin is an independent indicator in predicting early mortality in the patients with ICH.

关 键 词：脂联素 脑出血 

分 类 号：R743[医药卫生—神经病学与精神病学]