颅内动脉瘤性蛛网膜下腔出血病人组织蛋白酶S、血小板反应蛋白-1水平与预后的关系  

Relationships between Plasma Cathepsin S and Platelet Reactive Protein-1 Levels and Prognosis in Patients with Intracranial Aneurysmal Subarachnoid Hemorrhage

作　　者：鲁刚 吴中亚 李浩 LU Gang;WU Zhongya;LI Hao(Xinyang Central Hospital,Xinyang 464000,Henan,China)

机构地区：[1]信阳市中心医院,河南信阳464000

出　　处：《中西医结合心脑血管病杂志》2020年第21期3692-3696,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：河南省医学科技攻关计划项目(No.201604137)。

摘　　要：目的观察颅内动脉瘤性蛛网膜下腔出血(aSAH)病人血浆组织蛋白酶S(Cat S)、血小板反应蛋白-1(TSP-1)表达水平,并探讨二者与病人临床预后的关系。方法选取2016年11月—2018年10月信阳市中心医院收治的62例颅内aSAH病人作为研究对象,选取同期56名体检正常者作为对照组,通过酶联免疫吸附法(ELISA)检测所有研究对象血浆Cat S、TSP-1水平,术后3个月进行随访,根据格拉斯哥预后量表(GOS)评分将病人分为预后良好组和预后不良组,分析血浆Cat S、TSP-1水平对病人预后的影响。结果与对照组相比,aSAH组血浆Cat S、TSP-1水平明显升高(P<0.05);与预后良好组相比,预后不良组血浆Cat S、TSP-1水平明显升高(P<0.05);单因素分析显示,年龄、Fisher分级、Hunt-Hess分级、动脉瘤大小、高血压史、吸烟史是影响aSAH病人预后的相关因素。多因素Logistic回归分析显示,Fisher分级Ⅲ级或Ⅳ级、Hunt-Hess分级Ⅲ级或Ⅳ级及血浆Cat S、TSP-1水平高是aSAH病人预后的危险因素(P<0.05)。ROC曲线显示,血浆Cat S水平预测aSAH病人不良预后的曲线下面积为0.797(敏感度为75.0%,特异性为88.1%)。血浆TSP-1水平预测aSAH病人不良预后的曲线下面积为0.777(敏感度为65.0%,特异性为90.5%)。结论血浆Cat S、TSP-1水平在aSAH病人中高表达,Cat S、TSP-1水平升高与病人不良预后相关。Objective To observe the expressions of plasma cathepsin S(Cat S)and thrombospondin-1(TSP-1)in patients with intracranial aneurysmal subarachnoid hemorrhage(aSAH),and to explore their relationships with clinical prognosis.Methods Sixty-two patients with intracranial aSAH were selected as the study subjects,and 56 patients with normal physical examination in the same period were selected as control group.The levels of plasma Cat S and TSP-1 were detected by enzyme-linked immunosorbent assay(ELISA),follow-up was conducted 3 months after operation,according to Glasgow Prognosis Score(GOS),patients were divided into good prognosis group and bad prognosis group.The effect of plasma Cat S and TSP-1 levels on the prognosis of patients was analyzed.Results Compared with control group,the levels of plasma Cat S and TSP-1 in aSAH group increased significantly(P<0.05).Compared with datain good prognosis group,the levels of plasma Cat S and TSP-1 in poor prognosis group increased significantly(P<0.05).Age,Fisher grade,Hunt-Hess grade,aneurysm size,hypertension,and smoking were the related factors affecting the prognosis of aSAH patients(P<0.05).Multivariate logistic regression analysis showed that Fisher gradeⅢ-Ⅳ,Hunt-Hess gradeⅢ-Ⅳ,high plasma Cat S and TSP-1 levels were risk factors for poor prognosis(P<0.05).ROC curve showed that the area under the curve of plasma Cat S level in predicting poor prognosis of aSAH patients was 0.797(sensitivity was 75.0%,specificity was 88.1%),the area under the curve of plasma TSP-1 level in predicting poor prognosis of aSAH patients was 0.777(sensitivity was 65.0%,specificity was 90.5%).Conclusion The levels of plasma Cat S and TSP-1 were higher in patients with intracranial aSAH,the high levels of plasma Cat S and TSP-1 are related with poor prognosis.

关 键 词：颅内动脉瘤性蛛网膜下腔出血 组织蛋白酶S 血小板反应蛋白-1 预后 颅内动脉瘤 蛛网膜下腔出血 

分 类 号：R743[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]