动脉瘤性蛛网膜下腔出血患者脑血管痉挛及预后与血浆骨桥蛋白水平的关系  

Correlation between cerebral vasospasm and prognosis in aneurysmal subarachnoid hemorrhage and plasma osteopontin level

作　　者：孙剑瑞[1] 王琳[2] Sun Jianrui;Wang Lin(Department of Neurosurgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Information Office,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院神经外科,450052 [2]郑州大学第一附属医院信息处,450052

出　　处：《中华实验外科杂志》2022年第6期1169-1172,共4页Chinese Journal of Experimental Surgery

基　　金：河南省自然科学基金(212300410401)。

摘　　要：目的探讨血浆骨桥蛋白(OPN)水平与动脉瘤性蛛网膜下腔出血(aSAH)患者脑血管痉挛(CVS)及预后的关系。方法以郑州大学第一附属医院收治的96例aSAH患者为aSAH组, 根据是否发生CVS分为非CVS组(50例)和CVS组(46例), 发病3个月的改良Rankin量表(mRS)评分分为预后良好组(67例)和预后不良组(29例), 并收集同期健康体检者40例为对照组。应用单因素及多因素Logistic回归分析及受试者工作特征曲线(ROC)分析血浆OPN与CVS和预后的关系及预测价值。结果 aSAH组OPN水平高于对照组[(65.51±2.51) ng/ml比(5.25±0.68) ng/ml, t=149.278, P<0.05], 且CVS组OPN水平高于非CVS组[(66.78±11.44) ng/ml比(58.32±11.40) ng/ml, t=3.627, P<0.05], 预后良好组OPN水平低于预后不良组[(59.94±11.90) ng/ml比(67.99±10.87) ng/ml, t=3.123, P<0.05]。Logistic回归分析显示, OPN升高是aSAH并发CVS的独立危险因素(P<0.05), 也是aSAH患者预后不良的独立危险因素(P<0.05)。ROC曲线分析表明OPN预测CVS的曲线下面积(AUC)为0.697;预测aSAH患者不良预后的AUC为0.701。结论血浆OPN水平与aSAH并发CVS及不良预后密切相关。Objective To investigate the relationship between cerebral vasospasm(CVS)and prognosis in patients with aneurysmal subarachnoid hemorrhage(aSAH)and plasma osteopontin(OPN)level.Methods Totally,96 aSAH patients admitted to the authors’hospital were selected as aSAH group,and divided into non-CVS group(n=50)and CVS group(n=46)according to whether CVS occurred.According to the modified Rankin scale(mRS)score at 3rd month after onset,the aSAH group was divided into the good prognosis subgroup(n=67)and poor prognosis subgroup(n=29).A total of 40 healthy subjects were selected as the control group.Univariate and multivariate Logistic regression analysis and receiver operating characteristic(ROC)curve were used,and the relationship and predictive value of plasma OPN with CVS and prognosis were analyzed.Results The level of OPN in aSAH group was significantly higher than that in control group[(65.51±2.51)vs.(5.25±0.68)ng/ml,t=149.278,P<0.05].The level of OPN in CVS group was higher than non-CVS group[(66.78±11.44)vs.(58.32±11.40)ng/ml,t=3.627,P<0.05].The level of OPN in the good prognosis subgroup was lower than the poor prognosis subgroup[(59.94±11.90)vs.(67.99±10.87)ng/ml,t=3.123,P<0.05].Logistic regression analysis showed that increased OPN was an independent risk factor for aSAH complicated with CVS(P<0.05),and was also an independent risk factor for poor prognosis in aSAH patients(P<0.05).The ROC curve analysis showed that the area under curve(AUC)of CVS predicted by OPN was 0.697,and the AUC that predicted the adverse prognosis of aSAH patients was 0.701.Conclusion Plasma OPN level is closely related to aSAH complicated with CVS and poor prognosis.

关 键 词：动脉瘤性蛛网膜下腔出血 骨桥蛋白 血管痉挛 预后 

分 类 号：R743.35[医药卫生—神经病学与精神病学]