Ang-1、HO-1、NGF和MMSE评分在HICH疗效评价中的价值  

Roles of Ang-1,HO-1,NGF and MMSE scores in evaluation of HICH efficacy

作　　者：张春香 冀明明 孙敏玲 李建英 ZHANG Chunxiang;JI Mingming;SUN Minling;LI Jianying(Intensive Care Unit of Internal Medicine,Zhangjiakou First Hospital,Zhangjiakou 075000,Hebei,China;Emergency Intensive Care Unit,Zhangjiakou First Hospital,Zhangjiakou 075000,Hebei,China;Department of Rehabilitation,Zhangjiakou First Hospital,Zhangjiakou 075000,Hebei,China)

机构地区：[1]张家口市第一医院内科重症医学科,河北张家口075000 [2]张家口市第一医院急诊重症医学科,河北张家口075000 [3]张家口市第一医院康复科,河北张家口075000

出　　处：《检验医学》2024年第7期650-655,共6页Laboratory Medicine

基　　金：张家口市重点研发计划项目(2121160D)。

摘　　要：目的探讨血管生成素-1(Ang-1)、血红素氧化酶1(HO-1)、神经生长因子(NGF)和简易智能精神状态检查量表(MMSE)评分在高血压脑出血(HICH)疗效评估中的价值。方法选取2018年2月—2022年2月张家口市第一医院HICH患者152例(HICH组)和健康体检者68名(正常对照组)。所有患者均接受去骨瓣血肿清除术、支持治疗和脑蛋白水解物治疗,根据疗效分为有效组(105例)和无效组(47例)。分别检测HICH患者治疗前、治疗后和正常对照者的血清Ang-1、HO-1、NGF水平,采用MMSE评分评估HICH患者的认知功能。采用多因素Logistic回归分析评估HICH无效的危险因素。采用受试者工作特征(ROC)曲线评价Ang-1、HO-1、NGF、MMSE评分判断HICH疗效的效能。结果HICH组治疗前血清Ang-1、NGF水平和MMSE评分低于正常对照组(P<0.05),血清HO-1水平高于正常对照组(P<0.05)。有效组治疗后血清Ang-1、NGF水平和MMSE评分显著高于治疗前(P<0.05),血清HO-1水平低于治疗前(P<0.05);无效组治疗前、治疗后各项指标差异均无统计学意义(P>0.05)。无效组治疗前、治疗后血清Ang-1、NGF水平和MMSE评分均显著低于有效组(P<0.05),血清HO-1水平均显著高于有效组(P<0.05)。高血压3级和治疗前HO-1升高、Ang-1降低、NGF降低、MMSE评分降低是HICH患者治疗无效的危险因素[比值比(OR)值分别为2.324、1.442、0.549、0.671、0.716,95%可信区间(CI)分别为1.357~5.468、1.203~4.535、0.211~0.884、0.316~0.854、0.461~0.973,P<0.05]。血清Ang-1、HO-1、NGF水平和MMSE评分单项和联合检测判断HICH疗效的ROC曲线下面积(AUC)分别为0.859、0.848、0.856、0.820、0.958。结论血清Ang-1、NGF、HO-1水平与HICH患者的临床疗效有关,或可作为HICH疗效评估的潜在指标。Objective To evaluate the efficacy of angiopoietin-1(Ang-1),heme oxygenase 1(HO-1),nerve growth factor(NGF)and Mini-Mental State Examination(MMSE)score in hypertensive intracerebral hemorrhage(HICH).Methods Totally,152 patients with HICH(HICH group)and 68 healthy subjects(healthy control group)were enrolled from Zhangjiakou First Hospital from February 2018 to February 2022.All the patients were treated with bone flap hematoma removal,supportive therapy and brain proteolytic hydrolysate.According to the efficacy,they were classified into effective group(105 cases)and ineffective group(47 cases).Serum Ang-1,HO-1 and NGF levels of HICH and healthy groups before and after treatment were determined,and MMSE scores were used to evaluate the cognitive function of HICH patients.Multivariate Logistic regression analysis was used to evaluate the risk factors of HICH treatment failure.Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of Ang-1,HO-1,NGF and MMSE scores in judging the therapeutic effect of HICH.Results Before treatment,serum Ang-1,NGF and MMSE scores in HICH group were lower than those in healthy control group(P<0.05),and serum HO-1 levels in HICH group were higher than those in healthy control group(P<0.05).After treatment,serum Ang-1,NGF and MMSE scores in effective group were higher than those before treatment(P<0.05),and serum HO-1 levels were lower(P<0.05).There was no statistical significance between the 2 groups before and after treatment(P>0.05).Serum Ang-1,NGF levels and MMSE scores in ineffective group were lower than those in effective group before and after treatment(P<0.05),and serum HO-1 levels were higher than those in effective group(P<0.05).Grade 3 hypertension and pre-treatment increase of HO-1,decrease of Ang-1,decrease of NGF and decrease of MMSE scores were risk factors for treatment ineffectiveness in patients with HICH[odds ratios(OR)were 2.324,1.442,0.549,0.671 and 0.716,95%confidence intervals(CI)were 1.357-5.468,1.203-4.535,0.211-0.884,0.316-0.854 and 0.46

关 键 词：血管生成素-1 血红素氧化酶1 神经生长因子 高血压脑出血 认知障碍 

分 类 号：R446.1[医药卫生—诊断学]