血清骨桥蛋白水平与急性脑出血患者病情及预后的关系  

The relationship between serum osteopontin levels and severity and prognosis in acute cerebral hemorrhage

作　　者：徐叶[1] 黄思思[2] 何睿瑜[1] 田慧军[3] 

机构地区：[1]佛山市第一人民医院,佛山528000 [2]广州中山大学附属第一医院 [3]北京市解放军第309医院

出　　处：《内科急危重症杂志》2017年第3期189-191,200,共4页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨血清骨桥蛋白(OPN)水平变化与急性脑出血患者病情严重程度及预后的关系。方法:选取急性脑出血患者46例作为观察组,入院后24 h内进行NIHSS评分,根据CT计算脑出血体积,另选取同期健康体检者20例为对照组。采用ELISA法分别检测患者入院后1、7、14 d以及对照组体检当日血清OPN水平,比较不同脑出血量、不同神经功能缺损程度患者血清OPN水平的差异;3个月后行改良Rankin量表(MRS)评分评价预后情况。根据MRS评分分为预后良好亚组(MRS评分<3分)和预后不良亚组(MRS评分≥3分),采用Logistic回归分析影响预后的危险因素。结果:观察组患者血清OPN水平显著高于对照组[(8.0±3.2)ng/m L vs(4.1±2.2)ng/m L,P<0.05];脑出血患者入院后1、7、14 d血清OPN水平随着出血量的增多而逐渐升高(均P<0.01);并随着神经功能缺损程度的加重而逐渐升高(均P<0.01);预后不良亚组年龄、高敏C反应蛋白(hs-CRP)、脑出血体积、NIHSS评分、血清OPN水平明显高于预后良好亚组(P<0.05或P<0.01);Logistic回归分析显示,入院时NIHSS评分、血hs-CRP、OPN水平是影响脑出血患者预后的独立危险因素(均P<0.05)。结论:脑出血患者血清OPN水平增高,与脑出血量、神经功能缺损严重程度有关,是预后不良的独立危险因素,可为脑出血患者预后判断提供一定的参考依据。Objective： To explore the relationship between the change of serum osteopontin（ OPN） levels and severity and prognosis in acute cerebral hemorrhage. Methods： Forty-six patients with cerebral hemorrhage were selected as the observation group. The observation group was scored by NIHSS score within 24 h after admission. According to CT examinations,cerebral hemorrhage volume was calculated. Twenty healthy individuals who underwent physical examination during the same period of time were selected as the control group. Serum OPN levels were determined by ELISA on the day 1,7 and 14 after admission respectively in the observation group and medical examination day in control group,respectively. The levels of serum OPN in the patients with different volume of cerebral hemorrhage and different neurological deficits were compared. All patients were scored at 3rd month by modified Rankin scale（ MRS） to evaluate the prognosis. According to MRS,all patients were divided into two subgroups： good prognosis subgroup（ MRS 〈 3） and poor prognosis subgroup（ MRS≥3）. The risk factors that affected prognosis were analyzed by Logistic regression. Results： The levels of serum OPN in the observation group [（ 8. 0 ± 3. 2） ng/m L] were significantly higher than those of control group [（ 4. 1 ± 2. 2） ng/m L]（ P 〈 0. 05）. The serum OPN levels were gradually increased on the day 1,7,and 14 after admission with the gradual increases in cerebral hemorrhage volume（ all P 〈 0. 01）. The gradual increases in serum OPN levels was found on the day 1,7 and 14 after admission with the gradual aggravation of neurological deficit severity（ all P 〈 0. 01）. Age,hs-CRP,cerebral hemorrhage volume,NIHSS score and OPN levels in the poor prognosis subgroup were significantly increased as compared with those in the good prognosis subgroup（ P 〈 0. 05 or P 〈 0. 01）. Logistic regression analysis revealed that NIHSS at admission,hs-CRP and OPN were independent risk factors influencing the prognosis of p

关 键 词：脑出血 骨桥蛋白 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]