两种血清细胞因子水平对动脉瘤性蛛网膜下腔出血患者病情及预后的评估价值  

Values of serum CCR5 and SDF-1 levels in evaluating severity and predicting prognosis of aneurysmal subarachnoid hemorrhage

作　　者：高洋 梁慧敏 张建磊 许宏侠 Gao Yang;Liang Huimin;Zhang Jianlei;Xu Hongxia(Department of Neurology,Huaihe Hospital of Henan University,Kaifeng 475000,Henan Province,China)

机构地区：[1]河南大学淮河医院神经内科,开封475000 [2]河南大学第一附属医院老年病科

出　　处：《中华老年心脑血管病杂志》2023年第9期954-957,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190505)。

摘　　要：目的探讨血清CC趋化因子受体5(CCR5)、基质细胞衍生因子1(SDF-1)水平与动脉瘤性蛛网膜下腔出血(aSAH)患者病情严重程度的关系及其在预后中的预测价值。方法收集2019年1月至2022年8月河南大学淮河医院神经内科收治的aSAH患者100例作为aSAH组,aSAH组又根据格拉斯哥预后量表评分分为预后良好组68例和预后不良组32例。另收集本院健康体检者102例作为对照组。记录一般临床资料,采用酶联免疫吸附法检测血清CCR5、SDF-1水平。采用ROC曲线分析血清CCR5、SDF-1水平预测aSAH患者预后不良的价值。logistic回归分析aSAH患者预后不良的影响因素。结果aSAH组血清CCR5、SDF-1水平显著高于对照组,差异有统计学意义(P<0.01)。aSAH组世界神经外科医师联盟(WFNS)分级Ⅳ~Ⅴ级患者血清CCR5、SDF-1水平显著高于Ⅰ~Ⅲ级患者(P<0.01),改良Fisher分级Ⅲ~Ⅳ级患者血清CCR5、SDF-1水平显著高于Ⅰ~Ⅱ级患者(P<0.01)。预后不良组血清CCR5、SDF-1水平及WFNS分级Ⅳ~Ⅴ级患者比例显著高于预后良好组,差异有统计学意义(P<0.01)。ROC曲线分析显示,血清CCR5、SDF-1水平单独及联合预测aSAH患者预后不良的曲线下面积分别为0.822、0.834、0.914。多因素logistic回归分析显示,CCR5、SDF-1是aSAH患者预后不良的独立危险因素(OR=2.665,95%CI:1.366~5.200,P=0.004;OR=2.834,95%CI:1.640~4.897,P=0.000)。结论CCR5和SDF-1与aSAH患者病情相关,可作为预后预测的重要辅助参考指标。Objective To investigate the relationship of serum levels of chemokine C-C motif receptor type 5(CCR5)and stromal cell derived factor-1(SDF-1)with the severity of aneurysmal subarachnoid hemorrhage(aSAH)and explore their predictive value for prognosis.Methods A total of 100 aSAH patients admitted to Department of Neurology of Huaihe Hospital from January 2019 to August 2022 were recruited and assigned into the aSAH group.They were further divided into good(68 cases)and poor prognosis groups(32 cases)based on Glasgow Prognosis Scale score.Another 102 healthy individuals taking physical examination from the hospital served as the control group.General clinical data were recorded,and the serum levels of CCR5 and SDF-1 were detected by ELISA.ROC curve was plotted to analyze the value of serum CCR5 and SDF-1 levels in predicting poor prognosis in aSAH patients.Logistic regression analysis was applied to analyze the influencing factors of poor prognosis in them.Results The serum levels of CCR5 and SDF-1 were significantly higher in the aSAH group than the control group(P<0.01).Based on the results of World Federation of Neurosurgeons(WFNS)grading system for the aSAH patients,the serum levels of CCR5 and SDF-1 were obviously higher in those with WFNS gradeⅣtoⅤthan those with gradeⅠtoⅢ(P<0.01),and the serum levels in the patients with modified Fisher gradeⅢtoⅣwere significantly higher than those with gradeⅠtoⅡ(P<0.01).The poor prognosis group had notably higher serum levels of CCR5 and SDF-1 and larger proportion of patients with WFNS gradeⅣ-Ⅴwhen compared with the good prognosis group(P<0.01).ROC curve analysis showed that the AUC value of serum CCR5 and SDF-1 levels alone and in combination in predicting poor prognosis in aSAH patients was 0.822,0.834 and 0.914,respectively.Multivariate logistic regression analysis indicated that CCR5 and SDF-1 were independent risk factors for poor prognosis in aSAH patients(OR=2.665,95%CI:1.366-5.200,P=0.004;OR=2.834,95%CI:1.640-4.897,P=0.000).Conclusion CCR5 and

关 键 词：蛛网膜下腔出血 受体 CCR5 趋化因子CXCL12 预后 

分 类 号：R743.35[医药卫生—神经病学与精神病学]