动脉瘤性蛛网膜下腔出血患者血清Netrin-1浓度早期检测的临床价值  

The clinical value of early detection of netrin-1 concentration in patients with aneurysmal subarachnoid hemorrhage

作　　者：陈亦华[1] 程振宇[1] 申屠华松 邵林华[1] 傅斌[1] Chen Yihua

机构地区：[1]浙江省金华市人民医院,321000

出　　处：《浙江临床医学》2022年第2期198-200,203,共4页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2020KY1017)。

摘　　要：目的探讨血清Netrin-1浓度与动脉瘤性蛛网膜下腔出血(aSAH)患者预后的相关性。方法共收集aSAH患者和健康体检者各117例,分别作为aSAH组和对照组。采用酶联免疫吸附法测定两组的血清Netrin-1浓度,收集aSAH患者入院时的世界神经外科联盟(WFNS)评分、改良Fisher评分、血压、血糖水平、血C-反应蛋白浓度、血白细胞计数,以及性别、年龄、吸烟史、卒中至入院时间、卒中至采血时间、动脉瘤的位置形态直径、手术方法等临床资料,统计aSAH发生后6个月患者的生存及预后情况。采用二分类Logistic回归模型分析血清Netrin-1浓度与aSAH发生后6个月患者死亡和预后不良的关系。结果aSAH组患者的血清Netrin-1浓度较健康人群明显降低,差异有统计学意义(P<0.01)。aSAH患者血清Netrin-1浓度与其入院时的WFNS评分、改良Fisher评分均呈显著负相关性(P<0.01)。aSAH发生后6个月死亡或预后不良患者的血清Netrin-1浓度降低明显(P<0.01)。血清Netrhi-1浓度是aSAH发生后6个月患者死亡或预后不良的独立危险因素(P<0.05)。血清Netrin-1浓度与WFNS评分、改良Fisher评分的预后预测价值的受试者工作特征曲线下面积比较,差异均无统计学意义(P>0.05)。结论血清Netrin-1浓度与aSAH患者出血严重度和预后显著相关,血清Netrin-1可能是aSAH预后预测的潜在生物标志物。Objective To investigate the correlation between serum Netrin-1 concentration and prognosis in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods A total of 117 aSAH patients and 117 healthy subjects were collected as aSAH group and control group,respectively.Serum Netrin-1 concentration of the two groups was determined by enzyme linked immunosorbent assay.WFNS score,modified Fisher score,blood pressure,blood glucose level,blood C-reactive protein concentration and blood white blood cell count of aSAH patients at admission were collected.As well as clinical data such as gender,age,smoking history,time from stroke to admission,time from stroke to blood collection,location,shape and diameter of aneurysm,and surgical method,the survival and prognosis of patients 6 months after the occurrence of aSAH were analyzed.Binary Logistic regression model was used to analyze the relationship between serum Netrin-1 concentration and death and poor prognosis 6 months after aSAH.Results The serum Netrin-1 concentration in the aSAH group was significantly lower than that in the healthy group,and the difference was statistically significant(P<0.01).Serum Netrin-1 concentration of aSAH patients was significantly negatively correlated with WFNS score and modified Fisher score at admission(P<0.01).Semm Netrin-1 concentration were decreased significantly in patients who died or had poor prognosis 6 months after aSAH(P<0.01).Serum Netrin-1 concentration was an independent risk factor for death or poor prognosis 6 months after aSAH(P<0.05).There was no significant difference in the area under the operating characteristic curve between serum Netrin-1 concentration and WFNS score and modified Fisher score(P>0.05).Conclusion Serum Netrin-1 concentrations are closely correlated with hemorrhagic severity and outcome among aSAH patients,and thereby serum Netrin-1 might be a potential biomarkcr for aSAH prognostication.

关 键 词：血清Netrin-1 蛛网膜下腔出血 动脉瘤 预后预测 

分 类 号：R74[医药卫生—神经病学与精神病学]