血清缺氧诱导因子-1α、内皮素-1及基质金属蛋白酶-9联合检测对颅内动脉瘤破裂出血142例手术预后的价值  

Prognostic value of combined detection of serum HIF-1α,ET-1 and MMP-9 in 142 cases of ruptured intracranial aneurysm hemorrhage after surgery

作　　者：金祥兵[1] 邓明均[1] 吴晓宏[1] 丁冬官 陈伟[1] 王冰[1] 何强 JIN Xiangbing;DENG Mingjun;WU Xiaohong;DING Dongguan;CHEN Wei;WANG Bing;HE Qiang(Department of Neurosurgery,Dongtai People's Hospital,Dongtai,Jiangsu 224200,China)

机构地区：[1]东台市人民医院神经外科,江苏东台224200

出　　处：《安徽医药》2024年第6期1186-1191,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨血清缺氧诱导因子-1α(HIF-1α)、内皮素-1(ET-1)、基质金属蛋白酶-9(MMP-9)联合预测颅内动脉瘤破裂出血术后预后不良的价值。方法选取2020年1月至2022年1月东台市人民医院收治的颅内动脉瘤破裂出血病人142例作为研究组,另选取同期健康体检者140例作为对照组,检测病人术前、入院1周(均为术后)、术后6个月血清HIF-1α、ET-1、MMP-9水平并进行比较。另依据病人出院6个月后预后情况,将其分为预后良好组(101例)和预后不良组(41例),对比预后良好组和预后不良组术前、入院1周、术后6个月血清HIF-1α、ET-1、MMP-9水平,分析颅内动脉瘤破裂出血病人预后不良的影响因素及血清HIF-1α、ET-1、MMP-9单项及联合检测对颅内动脉瘤破裂出血病人预后不良的预测价值。结果研究组术前血清HIF-1α、ET-1、MMP-9水平均高于对照组(P<0.05);研究组随访6个月预后不良发生率为28.87%(41/142),血清HIF-1α、ET-1、MMP-9水平经重复测量方差分析差异有统计学意义(P<0.05),预后不良组入院1周、术后6个月血清HIF-1α(42.43±3.05)μg/L和(41.53±4.52)μg/L、ET-1(14.27±1.24)ng/L和(13.96±2.04)ng/L、MMP-9(15.57±1.81)μg/L和(14.68±2.65)μg/L均低于术前(51.19±4.38)μg/L、(16.50±1.45)ng/L、(18.26±2.29)μg/L;预后良好组入院1周、术后6个月血清HIF-1α(40.78±1.53)μg/L和(34.87±4.68)μg/L、ET-1(13.12±2.16)ng/L和(10.05±1.96)ng/L、MMP-9(14.87±1.20)μg/L和(12.21±2.87)μg/L均低于术前(47.82±4.13)μg/L、(14.89±2.75)ng/L、(17.41±1.21)μg/L;预后良好组术后6个月血清HIF-1α、ET-1、MMP-9水平均低于入院1周(P<0.05)。预后不良组术前、入院1周、术后6个月血清HIF-1α、ET-1、MMP-9水平均高于预后良好组(P<0.05)。预后不良组多发动脉瘤、脑积水、Hunt-Hess分级Ⅳ~Ⅴ级、CT Fisher分级3~4级、手术时机为≥72 h、并发脑血管痉挛、并发脑梗死病人占比均高于预后良好组(P<0.05);Hunt-Hess分级Ⅳ~�Objective To investigate the value of serum hypoxia-inducible factor-1α(HIF-1α),endothelin-1(ET-1),and matrix metalloproteinase-9(MMP-9)combined in predicting poor prognosis after intracranial aneurysm rupture hemorrhage.Methods A total of 142 patients with ruptured intracranial aneurysm hemorrhage admitted to Dongtai People's Hospital from January 2020 to January 2022 were selected as the study group,and another 140 healthy people who underwent medical checkups during same period were se-lected as the control group.The serum levels of HIF-1α,ET-1 and MMP-9 before the operation,1 week after admission(all postopera-tive)and 6 months after the operation were detected and compared.In addition,patients were divided into a good prognosis group(101 patients)and a poor prognosis group(41 patients)according to the prognosis 6 months after discharge,and the serum levels of HIF-1α,ET-1 and MMP-9 were compared between the good prognosis group and the poor prognosis group preoperatively,at 1 week after admis-sion,and at 6 months postoperatively.To analyze the factors influencing the poor prognosis of patients with intracranial ruptured aneu-rysm hemorrhage and the predictive value of serum HIF-1α,ET-1,and MMP-9 alone and in combination for the poor prognosis of pa-tients with intracranial ruptured aneurysm hemorrhage.Results The preoperative serum levels of HIF-1α,ET-1 and MMP-9 in the study group were greater than those in the control group(P<0.05).The incidence of poor prognosis in the study group was 28.87%(41/142)at the 6-month follow-up,and the levels of serum HIF-1α,ET-1 and MMP-9 were significantly different according to repeated-measures ANOVA(P<0.05).In the poor prognosis group,the serum HIF-1α[(42.43±3.05)μg/L and(41.53±4.52)μg/L]and ET-1[(14.27±1.24)ng/L and(13.96±2.04)ng/L]levels at 1 week after admission and 6 after admission and the MMP-9[(15.57±1.81)μg/L and(14.68±2.65)μg/L]level were lower than the preoperative level[(51.19±4.38)μg/L,(16.50±1.45)ng/L,and(18.26±2.29)μg/L,re-spectively].I

关 键 词：颅内动脉瘤 动脉瘤 破裂 缺氧诱导因子-1Α 内皮素-1 基质金属蛋白酶-9 预后 

分 类 号：R651.12[医药卫生—外科学]