高血压脑出血GSN、CCCK⁃18、NSE水平变化对神经功能的影响  

The effect of GSN,CCCK⁃18,NSE level changes on nerve function in hypertensive cere⁃bral hemorrhage

作　　者：张培松 刘怀新 任松涛 李鑫[1] 张培凯 时传迎 ZHANG Peisong;LIU Huaixin;REN Songtao;LI Xin;ZHANG Peikai;SHI Chuanying(Department of Neurosurgery,Liaocheng People's Hospital,Liaocheng,Shandong,China,252000;Department of Neurosurgery,Liaocheng Third People's Hospital,Liaocheng,Shandong,China,252000;Department of Imaging,Liaocheng People's Hospital,Liaocheng,Shandong,China,252000)

机构地区：[1]聊城市人民医院神经外科,山东聊城252000 [2]聊城市第三人民医院神经外科,山东聊城252000 [3]聊城市人民医院影像科,山东聊城252000

出　　处：《分子诊断与治疗杂志》2021年第4期522-525,530,共5页Journal of Molecular Diagnostics and Therapy

基　　金：2017年山东省医疗卫生科技发展计划项目(2017WS329);聊城市人民医院科研院级基金(LYQN201924)。

摘　　要：目的探究高血压脑出血(HCH)患者凝溶胶蛋白(GSN)、Caspase切割的细胞角蛋白18(CCCK⁃18)、神经元特异性烯醇化酶(NSE)水平变化情况,并分析其对患者神经功能的影响。方法选取本院HCH患者108例,根据出院时神经功能恢复情况分为恢复良好组(85例)与恢复不良组(23例),比较两组一般资料、研究组不同病情患者入院时血清GSN、CCCK⁃18、NSE水平,分析各指标临床意义。结果恢复不良组年龄、发病至入院时间、出血量(>30 mL)、神经功能缺损程度(重度)、合并糖尿病(是)、房颤史(有)均大于恢复良好组,差异均有统计学意义(P<0.05);血清CCCK⁃18、NSE水平随出血量增加、神经功能缺损程度增加呈逐渐升高趋势,GSN水平随出血量增加、神经功能缺损程度增加呈逐渐降低趋势(P<0.05);Spearman相关性分析显示,入院时血清CCCK⁃18、NSE水平与出血量(r=0.766、0.711)、神经功能缺损程度(r=0.767、0.704)呈正相关,血清GSN与出血量、神经功能缺损程度(r=-0.846、-0.872)呈负相关(P<0.05);恢复不良组入院时、治疗7 d后血清CCCK⁃18、NSE水平高于恢复良好组,GSN水平低于恢复良好组,差异有统计学意义(P<0.05);恢复良好组治疗7 d后血清CCCK⁃18、NSE水平低于入院时,GSN水平高于入院时(P<0.05);Logistic回归分析显示,年龄、发病至入院时间、合并糖尿病、房颤史、入院时、治疗7 d后血清GSN、CCCK⁃18、NSE是HCH患者神经功能恢复的影响因素(P<0.05)。结论HCH患者GSN、CCCK⁃18、NSE水平变化是神经功能恢复的影响因素。Objective To investigate the changes of gelsolin(GSN),caspase⁃cleaved cytokeratin18(CCCK⁃18)and neuronal⁃specific enolase(NSE)levels in patients with hypertensive cerebral hemorrhage(HCH),and to analyze the effects on the neurological function of patients.Methods A total of 108 HCH patients in our hospital were selected and divided into a good recovery group(85 cases)and a poor recovery group(23 cases)according to the recovery of neurological function at the time of discharge.The general data of the two groups and the serum GSN,CCCK⁃18 and NSE levels of patients with different conditions in the study group when admitted to the hospital were compared,and the clinical significance of each indicator was analyzed.Results The age,time from onset to hospital admission,blood loss(>30 mL),degree of neurological impairment(severe),diabetes(yes),and atrial fibrillation history(yes)in the poor recovery group were greater than those in the good recovery group,and the differences were statistically significant(P<0.05).Serum CCCK⁃18 and NSE levels showed a gradual increase trend with the increase in bleeding volume and neurological deficit.The GSN level showed a gradual decrease trend with the increase in bleeding volume and neurological deficit(P<0.05).Spearman correlation analysis showed that serum CCCK⁃18 and NSE levels at admission were positively correlated with blood loss(r=0.766,0.711)and the degree of neurological impairment(r=0.767,0.704).Serum GSN was negatively correlated with blood loss and neurological impairment(r=-0.846,-0.872)(P<0.05).serum CCCK⁃18 and NSE levels in the poor recovery group were higher than those in the good recovery group at admission and 7 days after treatment,and the GSN level was lower than that in the good recovery group,and the difference was statistically significant(P<0.05).The level of serum CCCK⁃18 and NSE in the good revovery group was lower than those at admission,and the level of GSN was higher than that at admission(P<0.05).Logistic regression analysis showed that a

关 键 词：高血压脑出血 凝溶胶蛋白 Caspase切割的细胞角蛋白18 神经元特异性烯醇化酶 

分 类 号：R743.34[医药卫生—神经病学与精神病学]