血清透明质酸水平与急性自发性脑出血患者转归的相关性  

Correlation between the serum hyaluronic acid level and the outcomes in patients with acute spontaneous intracerebral hemorrhage

作　　者：郝璞珩[1] 李娜[2] 金林[1] 张冬子[1] 陈斌[1] 闫志丰[1] 王元刚[1] 

机构地区：[1]西安医学院第一附属医院神经外科,710077 [2]西安交通大学第一附属医院,710061

出　　处：《国际脑血管病杂志》2016年第9期810-814,共5页International Journal of Cerebrovascular Diseases

基　　金：陕西省教育厅科研计划项目（16JK1656）

摘　　要：目的探讨脑出血患者血清透明质酸水平与临床转归的相关性。方法纳入明确诊断为急性自发性脑出血的患者，记录基线临床资料，在入院24h内检测血清透明质酸水平，在发病3个月后采用改良Rankin量表评价临床转归，分为转归良好组（0～2分）和转归不良组（〉2分），对2组临床资料进行比较和分析。结果共纳入321例患者，转归良好组184例，转归不良组137例。转归良好组年龄[（46．3±8．6）岁对（62．4±10．5）岁；t=3．761，P=0．025]、体质指数[（24．1±5．3）kg／m^2对（27．8±6．1）kg／m^2；t=6．193，P=0．013]、血肿体积[（59．7±9．7）ml对（89．2±14．9）ml；t=6．278，P〈0．001]、基线格拉斯哥昏迷量表（GlasgowComaScale，GCS）评分[（6．3±1．5）分对（3．9±0．7）分；t=9．121，P〈0．001]、基线美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分[（9．6±1．5）分对（16．3±4．5）分；t=9．989，P〈0．00t]和血清透明质酸水平[（376．2-I-22．9）ng／ml对（876．14-19．6）ng／ml；t=19．681，P〈0．001]与转归不良组存在显著统计学差异。多变量logistic回归分析显示，透明质酸[优势比（oddsratio，OR）4．396，95％可信区间（COn砌enceinterval，CI）1．912～6．897；P〈0．001I、血肿体积（OR 2．328，95％CI 1．912～3．843；P=0．013）、NIHSS评分（OR 2．662，95％CI 1．127～2．976；P=0．023）和GCS评分（OR0．879，95％C10．097～0．969；P=0．046）是影响脑出血患者转归的独立因素。结论基线血清透明质酸水平增高是急性自发性脑出血患者转归不良的独立预测因素。Objective To investigate the correlation between the serum hyaluronic acid level and the outcomes in patients with intracerebral hemorrhage. Methods The patients definitely diagnosed as acute spontaneous intracerebral hemorrhage were enrolled. The baseline clinical data were documented. The serum hyaluronic acid level was detected within 24 h after admission. The modified Rankin Scale （mRS） was used to evaluate the clinical outcome at day 90 after onset. They were divided into a good outcome group （mRS 0-2） and a poor outcome group （mRS 〉2）. The clinical data of both groups were compared and analyzed. Results A total of 321 patients were enrolled, including 184 in the good outcome group and 137 in the poor outcome group. There were significant differences in age （46.3 ± 8. 6 years vs. 62.4 ±10. 5 years; t = 3.761, P = 0. 025）, body mass index （24. 1± 5.3 kg/m^2 vs. 27. 8 ±6. 1 kg/m^2; t = 6. 193, P = 0. 013）, hematoma volume （59. 7 ±9. 7 ml vs. 89. 2± 14. 9 ml; t =6. 278, P〈0. 001）, Glasgow coma scale （GCS） score （6. 3 ± 1.5 vs. 3.9 s0. 7; t = 9. 121, P 〈 0. 001）, baseline National Institutes of Health Stroke Scale （NIHSS） score （9.6 ± 1.5 vs. 16. 3±4. 5; t =9. 989, P 〈0. 001）, and serum hyaluronic acid level （376.2 22. 9 ng/ml vs. 876. 1± 19. 6 ng/ml; t = 19. 681, P 〈0. 001） between the good outcome group and the poor outcome group. Multivariate logistic regression analysis showed that the hyaluronic acid （odds ratio [ OR] 4. 396, 95% confidence interval [ CI]1. 912-6. 897; P 〈 0. 001）, hematoma volume （OR 2. 328, 95% CI 1. 912-3.843; P =0. 013）, NIHSS score （OR 2. 662, 95% CI 1. 127-2. 976; P =0. 023）, and GCS score （OR 0. 879, 95% CI 0. 097-0. 969; P = 0. 046 ） were the independent risk factors for affecting the outcomes in patients with acute spontaneous intracerebral hemorrhage. Conclusion The increased baseline serum hyaluronic acid level is an independent risk predictor of the poor outcomes in patients with acute spontaneous

关 键 词：脑出血 透明质酸 预后 生物标志物 危险因素 

分 类 号：R743.34[医药卫生—神经病学与精神病学]