TIMP-1/MMP-9、HPA、Nogo-A对高血压脑出血病情评估及手术预后预测的价值  

Values of TIMP-1/MMP-9,HPA and Nogo-A in Evaluation of Conditions of Patients with Hypertensive Cerebral Hemorrhage and in Prediction of Prognosis after Surgery

作　　者：李博 王淼 侯智 蒋铭 LI Bo;WANG Miao;HOU Zhi;JIANG Ming(Department of Neurosurgery,People's Hospital of Kaizhou District,Chongqing 405400,China;Department of Neurosurgery,the Second Affiliated Hospital of Army Medical University,Chongqing 400030,China)

机构地区：[1]重庆市开州区人民医院神经外科,重庆405400 [2]陆军军医大学第二附属医院神经外科,重庆400030

出　　处：《临床误诊误治》2022年第4期88-93,共6页Clinical Misdiagnosis & Mistherapy

基　　金：重庆市自然科学基金面上项目(cstc2019jcyj-msxmX0369)。

摘　　要：目的探究基质金属蛋白酶组织抑制剂-1(TIMP-1)/基质金属蛋白酶-9(MMP-9)、乙酰肝素酶(HPA)、轴突生长抑制因子A(Nogo-A)对高血压脑出血病情评估及手术预后预测的价值。方法选取2018年2月—2021年2月116例高血压脑出血作为研究对象,均行手术治疗,根据术后1个月的格拉斯哥预后量表(GOS)评分将患者分为预后不良组36例与预后良好组80例。比较两组血清TIMP-1/MMP-9、HPA、Nogo-A水平,以及不同病情严重程度患者血清TIMP-1/MMP-9、HPA、Nogo-A水平。分析各血清指标与病情严重程度及手术预后的关系,并采用受试者工作特征(ROC)曲线评价各血清指标预测手术预后的价值。结果预后不良组血清TIMP-1/MMP-9、HPA、Nogo-A水平高于预后良好组(P<0.01);重度损伤和中度损伤高血压脑出血患者血清TIMP-1/MMP-9、HPA、Nogo-A水平高于轻度损伤患者,且重度损伤患者高于中度损伤患者(P<0.05)。血清TIMP-1/MMP-9、HPA、Nogo-A与病情严重程度呈正相关(P<0.01),且与手术预后独立相关(P<0.05)。血清TIMP-1/MMP-9、HPA、Nogo-A联合预测手术预后的ROC曲线下面积为0.903,敏感度为86.11%,特异度为87.50%,明显高于各指标单独预测。结论血清TIMP-1/MMP-9、HPA、Nogo-A与高血压脑出血病情严重程度具有相关性,检测上述指标可为临床评估病情、预测手术预后提供参考。Objective To explore values of tissue inhibitor of matrix metalloproteinase-1(TIMP-1)/matrix metalloproteinase-9(MMP-9),heparitinase(HPA)and neurite outgrowth inhibitor A(Nogo-A)in evaluation of conditions of patients with hypertensive intracerebral hemorrhage(HIH)and in prediction of prognosis after surgery.Methods A total of 116 patients with HIH between February 2018 and February 2021 were selected as research subjects,and all patients underwent surgical treatments.According to Glasgow outcome scale(GOS)scores after operation for 1 month,the patients were divided into poor prognosis group(n=36)and good prognosis group(n=80).Serum levels of TIMP-1/MMP-9,HPA and Nogo-A were compared between two groups and in patients with different severity of conditions.Correlations between serum indexes with the severity of the disease and the prognosis after surgery were analyzed,and values of serum indexes in prediction of prognosis after surgery were evaluated by receiver operating characteristic(ROC)curve.Results Serum levels of TIMP-1/MMP-9,HPA and Nogo-A in poor prognosis group were significantly higher than those in good prognosis group(P<0.01).Serum levels of TIMP-1/MMP-9,HPA and Nogo-A in HIH patients with severe and moderate injury were significantly higher than those in patients with mild injury,and the levels in patients with severe injury were significantly higher than those in patients with moderate injury(P<0.05).Serum TIMP-1/MMP-9,HPA and Nogo-A were positively correlated with the severity of the disease(P<0.01),and independently correlated with surgical prognosis(P<0.05).The area under the ROC curve(AUC)of combination of serum TIMP-1/MMP-9,HPA and Nogo-A in prediction of the surgical prognosis was 0.903,and the sensitivity and specificity were 86.11% and 87.50% respectively,which were significantly higher than those predicted by each index alone.Conclusion Serum TIMP-1/MMP-9,HPA,Nogo-A are correlated with the severity of patients with HIH.The detection of the above indicators may provide a reference for clinic

关 键 词：脑出血 高血压 基质金属蛋白酶组织抑制剂-1 基质金属蛋白酶-9 乙酰肝素酶 轴突生长抑制因子A 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]