急性脑出血入院时CT脑中线移位和血清CCR5、Nogo-A水平与患者预后的相关性  

Correlation between CT midline shift,serum CCR5,Nogo-A levels and prognosis of patients with acute cerebral hemorrhage at admission

作　　者：冷静思 唐媛媛 林灵 LENG Jing-si;TANG Yuan-yuan;LIN Ling(Department of Neurosurgery,West China Hospital,Sichuan University,Chengdu Sichuan 610000,China)

机构地区：[1]四川大学华西医院神经外科,四川成都610000

出　　处：《临床和实验医学杂志》2023年第18期1914-1918,共5页Journal of Clinical and Experimental Medicine

基　　金：四川省科技计划项目(编号:2020SJ0246)。

摘　　要：目的探讨急性脑出血入院时CT脑中线移位、血清趋化因子受体5(CCR5)、轴突生长抑制因子A(Nogo-A)水平与患者预后的相关性。方法采用前瞻性研究方法,选取2021年1月至2022年7月在四川大学华西医院治疗的急性脑出血患者109例作为观察组,同时选取同期在四川大学华西医院健康体检志愿者100名作为对照组。比较两组血清CCR5、Nogo-A水平,同时分析观察组不同临床特征患者血清CCR5、Nogo-A水平差异,以及不同预后患者CT脑中线移位、CCR5和Nogo-A水平差异。采用受试者工作特征(ROC)曲线分析CT脑中线移位、血清CCR5、Nogo-A水平预测患者预后的价值。结果观察组血清CCR5、Nogo-A水平分别为(20.20±2.32)mg/L和(180.20±16.65)ng/mL,均显著高于对照组[(9.34±1.82)mg/L、(114.43±14.42)ng/mL],差异均有统计学意义(P<0.05)。观察组中重度患者血清CCR5和Nogo-A水平均显著高于轻度患者,差异均有统计学意义(P<0.05)。观察组中大量出血患者血清CCR5和Nogo-A水平均高于少量出血患者,差异均有统计学意义(P<0.05)。血清CCR5、Nogo-A与NIHSS评分呈正相关(r=0.354、0.332,P<0.05),与出血量呈正相关(r=0.328、0.339,P<0.05)。观察组预后不良患者CT脑中线移位、血清CCR5和Nogo-A分别为(4.98±1.21)mm、(23.30±2.22)mg/L和(198.29±17.20)ng/mL,均显著高于预后良好患者[(2.50±1.01)mm、(18.54±2.31)mg/L和(170.52±18.15)ng/mL],差异均有统计学意义(P<0.05)。CT脑中线移位、血清CCR5、Nogo-A水平预测预后不良的ROC曲线下面积分别为0.938、0.820和0.895,预测价值较好(P<0.05)。结论急性脑出血患者血清CCR5、Nogo-A水平升高,与患者病情严重程度、脑出血量呈正相关,CT脑中线移位、血清CCR5和Nogo-A水平在预测患者预后方面有一定应用价值。Objective To investigate the correlation between CT midline shift,serum chemokine receptor 5(CCR5),axon growth inhibitor A(Nogo-A)levels and prognosis of patients with acute cerebral hemorrhage at admission.Methods The prospective research method were used,109 patients with acute cerebral hemorrhage who were treated in West China Hospital,Sichuan University from January 2021 to July 2022 were selected as the observation group,and 100 healthy volunteers in West China Hospital,Sichuan University at the same time were selected as the control group,the levels of serum CCR5 and Nogo-A in the two groups were compared,and the differences of serum CCR5 and Nogo-A levels in patients with different clinical characteristics in the observation group were analyzed,as well as the differences of CT midline shift,CCR5 and Nogo-A levels in patients with different prognosis.The value of CT midline shift,serum CCR5,and Nogo-A levels in predicting patient prognosis was analyzed using the receiver operating characteristic(ROC)curve.Results The levels of serum CCR5 and Nogo-A in the observation group were(20.20±2.32)mg/L and(180.20±16.65)ng/mL,respectively,which were significantly higher than those in the control group[(9.34±1.82)mg/L,(114.43±14.42)ng/mL],the differences were statistically significant(P<0.05).The serum levels of CCR5 and Nogo-A in moderate to severe patients of the observation group were significantly higher than those in mild patients,and the differences were statistically significant(P<0.05).The serum levels of CCR5 and Nogo-A in patients with significant bleeding of the observation group were higher than those in patients with minimal bleeding,and the differences were statistically significant(P<0.05).Serum CCR5,Nogo-A were positively correlated with NIHSS scores(r=0.354,0.332,P<0.05),and with bleeding volume(r=0.328,0.339,P<0.05).CT brain midline shift,serum CCR5 and Nogo-A in patients with poor prognosis in the observation group were(4.98±1.21)mm,(23.30±2.22)mg/L and(198.29±17.20)ng/mL,respectively,which w

关 键 词：急性脑出血 CT脑中线移位 趋化因子受体5 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]