蛛网膜下腔出血患者血清sCD40L、YKL-40水平及其与脑血管痉挛的相关性  

Levels of serum sCD40L and YKL-40 in patients with subarachnoid hemorrhage and their correlation with cerebral vasospasm

作　　者：张丽平 李晓宇 龚珊珊 马海峰[1] ZHANG Liping;LI Xiaoyu;GONG Shanshan;MA Haifeng(Department of Neurology,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院神经内科,河北张家口075000

出　　处：《检验医学与临床》2024年第10期1349-1353,共5页Laboratory Medicine and Clinic

基　　金：河北省2022年度医学科学研究课题(20221891)。

摘　　要：目的分析可溶性CD40配体(sCD40L)、人软骨糖蛋白-39(YKL-40)在蛛网膜下腔出血(SAH)并发脑血管痉挛(CVS)患者血清中的水平及意义。方法选取该院2020年7月至2023年4月收治的SAH患者131例为研究对象,按照是否并发CVS分为CVS组(50例)和无CVS组(81例),并按CVS严重程度将CVS组患者分为轻症组(17例)、中症组(21例)、重症组(12例)。采用酶联免疫吸附试验(ELISA)检测血清sCD40L、YKL-40水平;采用Pearson相关分析SAH并发CVS患者血清sCD40L水平与YKL-40水平的相关性;采用Spearman相关分析血清sCD40L、YKL-40水平与CVS严重程度的相关性;采用多因素Logistic回归分析SAH并发CVS的影响因素。结果CVS组年龄、血肿体积明显大于无CVS组,入院时Fisher评分、血清sCD40L和YKL-40水平明显高于无CVS组,差异均有统计学意义(P<0.05)。血清sCD40L和YKL-40水平在轻症组、中症组、重症组中依次升高,两两组间比较,差异均有统计学意义(P<0.05)。SAH并发CVS患者血清sCD40L水平和YKL-40水平呈正相关(r=0.544,P<0.001)。CVS严重程度与血清sCD40L、YKL-40水平呈正相关(r=0.632、0.584,P<0.001);年龄、Fisher评分、血清sCD40L和YKL-40水平是SAH并发CVS的独立影响因素(P<0.05)。结论SAH并发CVS患者血清sCD40L和YKL-40水平升高,血清sCD40L和YKL-40水平与CVS严重程度呈正相关,二者均为SAH并发CVS的独立影响因素。Objective To analyze the serum levels and significance of soluble CD40 ligand(sCD40L)and human cartilage glycoprotein-39(YKL-40)in patients with subarachnoid hemorrhage(SAH)complicated with cerebral vasospasm(CVS).Methods A total of 131 SAH patients admitted to the First Affiliated Hospital of Hebei North University from July 2020 to April 2023 were selected as the research objects.According to whether they were complicated with CVS,they were divided into CVS group(50 cases)and non-CVS group(81 cases),and according to the severity of CVS,patients in the CVS group were divided into mild group(17 cases),moderate group(21 cases)and severe group(12 cases).Serum levels of sCD40L and YKL-40 were detected by enzyme-linked immunosorbent assay(ELISA).Pearson correlation was used to analyze the correlation between serum sCD40L level and YKL-40 level in CVS group.Spearman correlation analysis was used to analyze the correlation between sCD40L,YKL-40 levels and the severity of CVS.Multivariate Logistic regression was used to analyze the influencing factors of SAH complicated with CVS.Results Age,hematoma volume were significantly older or greater than those in non-CVS group,Fisher score,serum sCD40L and YKL-40 levels on admission in CVS group were significantly higher than those in non-CVS group(P<0.05).The serum levels of sCD40L and YKL-40 in the mild group,the moderate group and the severe group increased in turn,the differences were statistically significant(P<0.05).There was a positive correlation between serum sCD40L level and YKL-40 level in CVS group(r=0.544,P<0.001).The severity of CVS correlated positively with serum sCD40L and YKL-40 levels(r=0.632,0.584,P<0.001).Age,Fisher score,serum sCD40L and YKL-40 levels were independent influencing factors for SAH complicated with CVS(P<0.05).Conclusion The serum levels of sCD40L and YKL-40 increase in SAH patients complicated with CVS.The serum levels of sCD40L and YKL-40 correlate positively with the severity of CVS,the two indicators are independent influencing factors fo

关 键 词：蛛网膜下腔出血 脑血管痉挛 可溶性CD40配体 人软骨糖蛋白-39 相关性 

分 类 号：R743[医药卫生—神经病学与精神病学]