出血性脑卒中患者血清PDGF-D GDF-15及D-二聚体水平与颅内血肿扩大的相关性  

Correlation between serum levels of PDGF-D,GDF-15 and D-dimer and intracranial hematoma enlargement in the patients with hemorrhagic stroke

作　　者：翁磊华 陈星宇[1] 阳清伟[1] 陈中杰[1] 陈良义[1] WENG Leihua;CHEN Xingyu;YANG Qingwei;CHEN Zhongjie;CHEN Liangyi(Zhongshan Hospital,Xiamen University,Xiamen 361004,China)

机构地区：[1]厦门大学附属中山医院,福建厦门361004

出　　处：《中国实用神经疾病杂志》2024年第7期793-797,共5页Chinese Journal of Practical Nervous Diseases

基　　金：福建省自然科学基金项目(编号:2020J05290)。

摘　　要：目的分析血清血小板源性生长因子-D(PDGF-D)、生长分化因子-15(GDF-15)及D-二聚体与出血性脑卒中患者血肿扩大的相关性。方法选取2021-01-2023-01厦门大学附属中山医院神经内科诊治的出血性脑卒中患者197例,根据颅内血肿是否扩大分为血肿未扩大组(119例)和血肿扩大组(78例),收集患者基线临床资料。利用酶联免疫吸附试验(ELISA)检测血清PDGF-D和GDF-15水平,采用凝血仪检测血清D-二聚体水平。比较2组患者入院时血肿量(V1)和复查时血肿量(V2),计算V2/V1比值。采用Logistic回归分析颅内血肿扩大的独立危险因素。结果与血肿未扩大组相比,血肿扩大组收缩压[(158.17±21.73)mmHg比(164.82±22.94)mmHg,P<0.05]、舒张压[(97.31±8.93)mmHg比(101.36±9.55)mmHg,P<0.05]、GCS评分[(13.52±1.31)分比(11.78±1.14)分,P<0.05]和血清PDGF-D[(498.73±40.32)ng/L比(596.91±45.82)ng/L,P<0.05]、GDF-15[(728.49±76.71)ng/L比(832.38±86.25)ng/L,P<0.05]、D-二聚体[(1.63±0.10)mg/L比(1.84±0.23)mg/L,P<0.05]水平及V2[(20.53±4.72)cm^(3)比(29.47±5.13)cm3,P<0.05]、V2/V1比值(1.04±0.31比1.42±0.43,P<0.05)均更高。Logistic回归分析显示,PDGF-D、GDF-15、D-二聚体、收缩压、舒张压及GCS评分均为出血性脑卒中患者发生颅内血肿扩大的独立危险因素(分别为OR=1.798、1.672、1.616、1.592、1.583、1.738,P<0.05)。结论血清PDGF-D、GDF-15及D-二聚体水平在发生颅内血肿扩大的出血性脑卒中患者中升高,均为血肿扩大的独立危险因素。Objective To investigate the correlation between serum platelet-derived growth factor-D(PDGF-D),growth differentiation factor-15(GDF-15)and D-dimer and intracranial hematoma enlargement in patients with hemorrhagic stroke.Methods A total of 197 hemorrhagicstroke patients admitted to the Department of Neurology,Zhongshan Hospital,Xiamen University from January 2019 to January 2023 were enrolled.According to whether the intracranial hematoma is enlarged,the 197 participants were divided into the non-hematoma enlargement group(n=119)and the hematoma enlargement group(n=78).The baseline clinical data were collected and compared.Serum levels of PDGF-D and GDF-15 were detected by enzyme-linked immunosorbent assay(ELISA),and serum D-dimer levels were detected by coagulation instrumentation.The volume of hematoma at admission(V1)and the volume of hematoma at re-examination(V2)were recorded and compared between the two groups,and the V2/V1 ratio was calculated.Logistic regression was implemented to analyze independent risk factors for intracranial hematoma enlargement.Results Compared with the non-hematoma enlargement group,systolic blood pressure((158.17±21.73)mmHg vs(164.82±22.94)mmHg,P<0.05),diastolic blood pressure((97.31±8.93)mmHg vs(101.36±9.55)mmHg,P<0.05),GCS score((13.52±1.31)points vs(11.78±1.14)points,P<0.05),PDGF-D((498.73±40.32)ng/L vs(596.91±45.82)ng/L,P<0.05),GDF-15((728.49±76.71)ng/L vs(832.38±86.25)ng/L,P<0.05),D-dimer((1.63±0.10)mg/L vs(1.84±0.23)mg/L,P<0.05),V2((20.53±4.72)cm3 vs(29.47±5.13)cm3,P<0.05)and V2/V1 ratios(1.04±0.31 vs 1.42±0.43,P<0.05)of hematoma enlargement group were significantly higher.Logistic regression analysis showed that PDGF-D,GDF-15,D-dimer,systolic blood pressure,diastolic blood pressure,and GCS scores were independent risk factors for intracranial hematoma enlargement in patients with hemorrhagic stroke(OR=1.798,1.672,1.616,1.592,1.583,1.738,respectively,P<0.05).Conclusion Serum levels of PDGF-D,GDF-15 and D-dimer are increased in patients with hemorrhagic strok

关 键 词：出血性脑卒中 血肿扩大 血小板源性生长因子-D 生长分化因子-15 D-二聚体 血清 

分 类 号：R743.34[医药卫生—神经病学与精神病学]