颅内压监测联合BDNF水平对颅内出血患者预后的诊断价值  

Diagnostic value of intracranial pressure monitoring combined with BDNF level on the prognosis of patients with intracranial hemorrhage

作　　者：岳世元 刘欣 张贺龙[1] 李硕[1] 高建国[1] 路伟[1] 李烨 YUE Shiyuan;LIU Xin;ZHANG Helong;LI Shuo;GAO Jianguo;LU Wei;LI Ye(Hebei Provincial Chest Hospital,Shijiazhuang 050000,China)

机构地区：[1]河北省胸科医院,河北石家庄050000

出　　处：《中国实用神经疾病杂志》2023年第7期810-814,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河北省2019年度医学科学研究课题(编号:20191022)。

摘　　要：目的分析颅内压监测联合脑源性神经营养因子(BDNF)水平对颅内出血患者预后的诊断价值。方法回顾性分析河北省胸科医院2018-04—2022-09收治的94例颅内出血患者的临床资料,根据格拉斯哥预后量表(GOS)评分94例患者分为预后良好组67例与预后不良组27例。对比连续动态监测颅内压相关指标[颅内压(ICP)、脑灌注压(CPP)]及BDNF水平,采用双变量Pearson直线相关性检验颅内压相关指标、BDNF水平与GOS评分的相关性,绘制ROC曲线,分析颅内压监测联合BDNF水平对颅内出血患者预后的诊断价值。结果预后不良组ICP均高于预后良好组,CPP、BDNF水平及GOS评分低于预后良好组,差异有统计学意义(P<0.05)。双变量Pearson直线相关性分析显示,GOS评分与ICP呈负相关(r<0,P<0.05),与CPP、BDNF水平呈正相关(r>0,P<0.05)。ROC曲线显示,ICP、CPP、BDNF水平及联合预测颅内出血患者预后良好的AUC分别为0.768(95%CI:0.661~0.875)、0.681(95%CI:0.554~0.781)、0.821(95%CI:0.721~0.921)、0.870(95%CI:0.794~0.947)。结论颅内压监测及BDNF水平与颅内出血患者预后密切相关,且两者联合可提高患者预后的预测价值。Objective To analyze the diagnostic value of intracranial pressure monitoring combined with brain derived neurotrophic factor(BDNF)levels on the prognosis of patients with intracranial hemorrhage.Methods The clinical data of 94 patients with intracranial hemorrhage from April 2018 to September 2022 in Hebei Chest Hospital were retrospectively analyzed.According to Glasgow outcome scale(GOS)score,the patients were divided into good prognosis group(n=27)and poor prognosis group(n=67).The continuous dynamic monitoring of intracranial pressure-related indicators(intracranial pressure(ICP),cerebral perfusion pressure(CPP))and BDNF levels were compared,and the bivariate Pearson linear correlation was used to test the correlation between intracranial pressure-related indicators and BDNF levels and GOS score.The ROC curve was drawn to analyze the diagnostic value of intracranial pressure monitoring combined with BDNF levels for the prognosis of patients with intracranial hemorrhage.Results The ICP of the poor prognosis group was higher than that of the good prognosis group,and the CPP,BDNF level and GOS score were lower than those of the good prognosis group with statistically significant differences(P<0.05).Bivariate Pearson linear correlation showed that GOS score had a negative correlation with ICP(r<0,P<0.05),and a positive correlation with CPP and BDNF level(r>0,P<0.05).The ROC curve showed the levels of ICP,CPP,and BDNF,and the AUC of the combination to predict a good prognosis for patients with intracranial hemorrhage to be 0.768(95%CI:0.661-0.875),0.681(95%CI:0.554-0.781),0.821(95%CI:0.721-0.921),and 0.870(95%CI:0.794-0.947),respectively.Conclusion The intracranial pressure monitoring and BDNF level are closely related to the prognosis of patients with intracranial hemorrhage,and the combination of the two can improve the predictive value of prognosis in patients.

关 键 词：颅内出血 颅内压监测 脑灌注压 脑源性神经营养因子 格拉斯哥预后量表 预后 

分 类 号：R651.15[医药卫生—外科学]