高血压性脑出血患者微创血肿清除术前血清ox-LDL、25-(OH)-D水平对脑水肿的预测价值  

The predictive study of serum ox-LDL,25-(OH)-D expression on brain edema in patients with hypertensive intracerebral hemorrhage before minimally invasive hematoma removal

作　　者：陈裕春 朱禛菁 CHEN Yuchun;ZHU Zhenjing(Complex Ward B,Hongqiao Campus,Huashan Hospital Affiliated to Fudan University,Shanghai 201399,China;Operating Room,Pudong Campus,Fudan University Affiliated Huashan Hospital,Shanghai 201206,China)

机构地区：[1]复旦大学附属华山医院虹桥院区综合病区B,上海201399 [2]复旦大学附属华山医院浦东院区手术室,上海201206

出　　处：《检验医学与临床》2023年第22期3319-3323,3327,共6页Laboratory Medicine and Clinic

摘　　要：目的分析高血压性脑出血(HICH)患者微创血肿清除术前血清氧化修饰低密度脂蛋白(ox-LDL)、25-羟维生素D[25-(OH)-D]水平对脑水肿的预测价值。方法选择2020年8月至2022年8月复旦大学附属华山医院虹桥院区75例HICH患者作为研究对象,根据术前血清ox-LDL水平将患者分为高水平ox-LDL组(ox-LDL≥50μg/dL)、低水平ox-LDL组(ox-LDL<50μg/dL),根据血清25-(OH)-D水平高低将患者分为高水平25-(OH)-D组(25-(OH)-D≥30 ng/mL)、低水平25-(OH)-D组[25-(OH)-D<30 ng/mL],比较各组术后48 h内脑水肿发生率,绘制受试者工作特征(ROC)曲线分析术前血清ox-LDL、25-(OH)-D水平对HICH患者微创血肿清除术后脑水肿的预测价值。结果不同血清ox-LDL、25-(OH)-D水平患者血肿体积、纤维蛋白原水平、脑水肿发生率比较,差异有统计学意义(P<0.05)。Point-biserial相关分析结果显示,HICH患者脑水肿发生情况与血清ox-LDL水平呈正相关(r=0.455,P<0.05),与血清25-(OH)-D水平呈负相关(r=-0.534,P<0.05);Pearson相关分析结果显示,血清ox-LDL水平与25-(OH)-D水平呈负相关(r=-0.444,P<0.05)。ROC曲线分析结果表明,术前血清ox-LDL、25-(OH)-D单独及联合检测预测HICH患者微创血肿清除术后脑水肿的曲线下面积(AUC)分别为0.777、0.768、0.839,联合检测的AUC最大。结论HICH患者微创血肿清除术前血清ox-LDL水平呈高表达、25-(OH)-D水平呈低表达,术前血清ox-LDL、25-(OH)-D水平对HICH患者微创血肿清除术后脑水肿具有较高的预测价值。Objective To analyze the predictive value of ox-modified low density lipoprotein(ox-LDL)and 25-hydroxyvitamin D[25-(OH)-D]expression in serum before removal of minimally invasive hematoma for brain edema in patients with hypertensive intracerebral hemorrhage(HICH).Methods A total of 75 patients with HICH in Hongqiao Campus,Huashan Hospital Affiliated to Fudan University from August 2020 to August 2022 were selected as the study objects.According to preoperative serum ox-LDL level,the patients were divided into high level ox-LDL group(ox-LDL≥50μg/dL)and low level ox-LDL group(ox-LDL<50μg/dL).Patients were also divided into high level 25-(OH)-D group[25(OH)D≥30 ng/mL]and low level 25-(OH)-D group[25-(OH)-D<30 ng/mL]according to the level of serum 25-(OH)-D,and the incidence of cerebral edema within 48 h after surgery was compared among all groups.To analyze the value of serum ox-LDL and 25-(OH)-D expression before surgery in predicting cerebral edema in patients with HICH after minimally invasive hematoma removal by Receiver Operating Characteristic(ROC)curve.Results There were significant differences on hematoma volume,fibrinogen level and incidence rate of cerebral edema among patients with different levels of ox-LDL and 25-(OH)-D(P<0.05).Point-biserial correlation analysis showed that cerebral edema in HICH patients correlated positively with serum ox-LDL level(r=0.455,P<0.05),and correlated negatively with serum 25-(OH)-D level(r=-0.534,P<0.05).Pearson correlation analysis showed that serum ox-LDL correlated negatively with the level of 25-(OH)-D(r=-0.444,P<0.05).The results of ROC curve showed that the area under the curve(AUC)of serum ox-LDL and 25-(OH)-D alone and in combination were 0.777,0.768 and 0.839 respectively,and the combined detection had the biggest AUC for brain edema after minimally invasive hematoma removal in HICH patients.Conclusion Serum ox-LDL expresses highly and 25-(OH)-D expresses lowly before the removal of minimally invasive hematoma in HICH patients with cerebral edema.Serum ox-

关 键 词：高血压性脑出血 微创血肿清除术 脑水肿 氧化修饰低密度脂蛋白 25-羟维生素D 

分 类 号：R741[医药卫生—神经病学与精神病学]