血清NF-кB、HA水平对急性自发性脑出血患者小骨瓣开窗血肿清除术后转归的预测价值  

Research on the serum NF-кB and HA levels in predicting the outcome of small bone flap fenestration hematoma in patients with acute spontaneous cerebral hemorrhage

作　　者：彭兆龙 乔路宽 陈跃东 申展 Peng Zhaolong;Qiao Lukuan;Chen Yuedong;Shen Zhan(Department of Neurosurgery,Nanyang Nanshi Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳南石医院神经外科,473000

出　　处：《中国实用医刊》2020年第24期48-52,共5页Chinese Journal of Practical Medicine

摘　　要：目的探讨血清核转录因子kappaB(NF-кB)、透明质酸(HA)水平对急性自发性脑出血(sICH)患者小骨瓣开窗血肿清除术后转归的预测价值。方法抽取2018年10月至2020年2月于南阳南石医院接受小骨瓣开窗血肿清除术治疗的79例sICH患者为研究对象,术后3个月时采用改良Rankin评分量表(mRS)评估患者预后并分组;设计一般资料调查问卷,询问患者基线资料,记录并比较两组基线资料,检测并比较两组血清NF-кB、HA水平,分析血清NF-кB、HA水平预测sICH患者小骨瓣开窗血肿清除术后预后不良风险价值。结果79例sICH患者小骨瓣开窗血肿清除术后21例(26.58%)预后不良;预后不良组NF-кB、HA水平均高于预后良好组,差异有统计学意义(P<0.05);组间其他资料比较差异未见统计学意义(P>0.05);经单因素分析后建立多元回归模型行多因素分析结果显示,NF-кB、HA过表达均是sICH患者小骨瓣开窗血肿清除术后预后不良的影响因素(OR>1,P<0.05);绘制受试者工作特征曲线(ROC曲线),结果显示,当血清NF-кB、HA的cut-off值分别取0.265 mmol/L、324.300 ng/ml时,可获得sICH患者骨瓣开窗血肿清除术后预后不良风险最佳预测价值,ROC曲线下面积(AUC)分别为0.874、0.878,有一定预测价值。结论sICH患者小骨瓣开窗血肿清除术后存在预后不良风险,可能与血清NF-кB、HA过表达有关,未来可考虑通过检测血清NF-кB、HA水平,指导早期预后不良风险评估,可对早期合理干预及改善sICH患者预后有积极意义。Objective To investigate the predictive value of serum nuclear transcription factor kappaB(NF-кB)and hyaluronic acid(HA)levels in patients with acute spontaneous intracerebral hemorrhage(sICH)after small bone flap fenestration hematoma.Methods A total of 79 patients with sICH who underwent small bone flap fenestration hematoma evacuation in Nanshi Hospital from October 2018 to February 2020 were selected as the research objects.Three months after surgery,the modified Rankin Rating Scale(mRS)was used to assess the prognosis of the patients and divided them into groups;a general information questionnaire was designed,the patient’s baseline information was asked,the baseline information of the two groups was recored and compared,the serum NF-кB and HA levels of the two groups were detected and compared,the value of serum NF-кB and HA levels in predicting the risk of poor prognosis in patients with sICH patients after small bone flap fenestration hematoma evacuation were analyzed.Results In 79 patients with sICH,21 patients(26.58%)underwent small bone flap fenestration and hematoma clearance;the levels of NF-кB and HA in the poor prognosis group were higher than those in the good prognosis group(P<0.05);other data between the two groups was compared,the difference was not statistically significant(P>0.05);after univariate analysis,a multivariate regression model was established and multivariate analysis was performed.The results showed that the overexpression of NF-кB and HA were the influencing factors of the poor prognosis of sICH patients after small bone flap fenestration hematoma evacuation(OR>1,P<0.05);the receiver opeating characteristic(ROC)curve was drawn,the result showed that when the cut-off values of serum NF-кB and HA were 0.265 mmol/L and 324.300 ng/ml,respectively,the best predictive value of the risk of poor prognosis after fenestration of sICH patients could be obtained.When the area under the ROC curve(AUC)were 0.874 and 0.878,there was a certain predictive value.Conclusions There is a risk

关 键 词：急性自发性脑出血 小骨瓣开窗血肿清除术 核转录因子KAPPAB 透明质酸 

分 类 号：R651.1[医药卫生—外科学]