血清基质金属蛋白酶-9、热休克蛋白47水平与急性脑出血术后预后的关系  

Analysis of correlation of serum matrix metalloproteinase-9 and heat shock protein-47 levels with prognosis in patients with acute cerebral hemorrhage

作　　者：王娜 孙伟伟 邢国靖 赵金雷 孙群 WANG Na;SUN Weiwei;XING Guojing;ZHAO Jinlei;SUN Qun(Department of Emergency,Zibo First Hospital,Zibo,Shandong 255200,China;不详)

机构地区：[1]山东省淄博市第一医院急诊,255200 [2]山东省淄博市精神卫生中心男一病区 [3]山东省淄博市中心医院超声医学科 [4]淄川区妇幼保健计划生育服务中心妇女保健部 [5]淄博市第一医院重症医学科

出　　处：《临床外科杂志》2024年第8期818-821,共4页Journal of Clinical Surgery

基　　金：山东省医药卫生科技发展计划项目(2018WS118)。

摘　　要：目的采用血清基质金属蛋白酶-9(MMP-9)、热休克蛋白47(HSP47)水平与急性脑出血术后预后的关系。方法2018年3月~2022年5月我院就诊急性脑出血病人145例,根据术后预后情况分为预后良好组(80例),预后不良组(65例)。收集病人的一般资料,采集病人入院次日的清晨空腹外周血,酶联免疫吸附法检测血清MMP-9、HSP47水平,采用多因素Logistic回归分析急性脑出血术后预后不良的危险因素,采用受试者工作曲线(ROC曲线)分析急性脑出血术后病人血清MMP-9、HSP47水平对其短期预后的预测价值。结果两组病人血肿形状是否规则、血肿量比较差异有统计学意义(P<0.05)。术后预后不良组的血清MMP-9、HSP47水平高于预后良好组,差异有统计学意义(P<0.05)。多因素Logistic回归显示,手术时间、血肿形状、血肿量、血清MMP-9、HSP47水平均是急性脑出血病人术后预后不良的危险因素(P<0.05),发病时间至手术时间>24小时、血肿形状不规则、血肿量多、血清MMP-9、HSP47水平越高的急性脑出血术后的病人,其发生预后不良的风险越大。ROC曲线分析表明,血清MMP-9、HSP47水平预测急性脑出血病人术后预后情况的AUC分别为0.718、0.827,灵敏度分别为81.5%、80.0%,特异度分别为50.0%、81.2%;两个指标联合预测的AUC为0.891,灵敏度为86.2%,特异度为85.0%。结论急性脑出血术后预后不良病人的血清MMP-9、HSP47水平均升高,血肿形状不规则、血肿量、血清MMP-9、HSP47水平均是术后预后不良的危险因素。血清MMP-9、HSP47水平对急性脑出血术后的预后情况具有较高的预测价值,且联合预测的效能更高。Objective To explore the correlation of serum matrix metalloproteinase-9(MMP-9)and heat shock protein-47(HSP-47)levels with prognosis in patients with acute cerebral hemorrhage.Methods One hundred and forty-five patients with acute cerebral hemorrhage attending our hospital from March 2018 to May 2022 were selected,and assigned into good prognosis group(n=80)and poor prognosis group(n=65)according to their postoperative prognosis.General information of patients was recorded.The early morning of the day after admission fasting peripheral venous blood samples were collected for the detection of serum MMP-9 and HSP47 levels.Multivariate Logistic regression analysis was conducted to screen the risk factors affecting poor prognosis in patients with acute cerebral hemorrhage,and the predictive value of serum MMP-9 and HSP47 levels on prognosis of patients with acute cerebral hemorrhage was evaluated by plotting ROC curve.Results Statistical difference was found in shape and volume of hematoma between two groups(P<0.05).Serum MMP-9 and HSP47 levels in poor prognosis group were higher than that in good prognosis group(P<0.05).Multivariate Logistic regression analysis denoted that duration of surgery,hematoma shape,hematoma volume,serum MMP-9 and HSP47 levels were all risk factors for poor prognosis in patients with acute cerebral hemorrhage(P<0.05).Patients with the time of onset to surgery>24 hours irregular shaped hematoma,large hematoma volume,and elevated serum levels of MMP-9 and HSP47 suffered a high risk of poor prognosis.ROC curve analysis demonstrated that AUC of serum MMP-9 and HSP47 levels for predicting the postoperative prognosis of patients with acute cerebral haemorrhage were 0.718 and 0.827,with a sensitivity of 81.5%and 80.0%,and a specificity of 50.0%and 81.2%,respectively.The AUC,sensitivity and specificity of combined detection of serum MMP-9 and HSP47 for prognosis prediction were 0.891,86.2%and 85.0%.Conclusion Serum MMP-9 and HSP47 levels are elevated in patients with poor prognosis after acute cer

关 键 词：基质金属蛋白酶-9 热休克蛋白47 急性脑出血 预后 ROC曲线 

分 类 号：R743.34[医药卫生—神经病学与精神病学]