FA、betatrophin、YKL-40预测高血压深部脑出血神经内镜术后再出血的价值  

Value of FA,Betatrophin and YKL-40 in Predicting Rebleeding After Neuroendoscopy in Hypertensive Deep Intracerebral Hemorrhage

作　　者：韩东[1] 夏国庆[1] 王东晓[1] 张方[2] HAN Dong;XIA Guoqing;WANG Dongxiao;ZHANG Fang(Department of Neurosurgery,the Second People’s Hospital of Jiaozuo,Jiaozuo 454100,China;Department of Integrated Traditional Chinese and Western Medicine,the Second People’s Hospital of Jiaozuo,Jiaozuo 454100,China)

机构地区：[1]焦作市第二人民医院神经外科,河南焦作454100 [2]焦作市第二人民医院中西医结合科,河南焦作454100

出　　处：《河南医学研究》2024年第19期3517-3521,共5页Henan Medical Research

基　　金：2020—2021年度河南省中医药科学研究专项课题(20-21ZY3041)。

摘　　要：目的探讨血清胎球蛋白(FA)、血管生成素样蛋白betatrophin、甲壳质酶蛋白-40(YKL-40)预测高血压深部脑出血神经内镜术后再出血的效果。方法选取2019年9月至2021年9月焦作市第二人民医院神经外科收治的169例高血压深部脑出血患者,均成功实施神经内镜术,根据术后48 h内是否发生再出血分为再出血组、无再出血组,比较两组一般资料与术前、术后即刻血清FA、betatrophin、YKL-40及三者手术前后差值,对相关数据进行统计学分析。结果再出血组血肿量、抗凝药物应用、脑疝患者多于无再出血组,入院时格拉斯哥昏迷评分法(GCS)评分低于无再出血组(P<0.05);再出血组术前、术后即刻血清FA、betatrophin、YKL-40高于无再出血组(P<0.05);血肿量、应用抗凝药物、脑疝、入院时GCS评分、血清FA、betatrophin与YKL-40手术前后差值均与术后再出血有关(P<0.05);血清FA、betatrophin与YKL-40手术前后差值预测再出血的受试者工作特征曲线下面积为0.748、0.779、0.788,三者联合的ROC曲线下面积为0.938;血清FA、betatrophin与YKL-40手术前后差值≥对应最佳截断值者再出血的危险度分别为小于对应截断值的4.412、7.464、6.033倍。结论血清FA、betatrophin、YKL-40与高血压深部脑出血神经内镜术后再出血有关,监测术前、术后即刻各指标变化有助于预测患者术后再出血的危险度,为临床治疗提供参考依据。Objective To investigate the efficacy of serum fetuin-A(FA),angiopoietin-like protein betatrophin and chitinase protein-40(YKL-40)in predicting rebleeding after neuroendoscopy for hypertensive deep intracerebral hemorrhage.Methods A total of 169 patients with hypertensive deep intracerebral hemorrhage in Neurosurgery Department,the Second People’s Hospital of Jiaozuo from September 2019 to September 2021 were selected,all of whom underwent neuroendoscopy successfully.In the bleeding group,the general data of the two groups were compared with the preoperative and postoperative serum FA,betatrophin,YKL-40 and the difference between the three before and after the operation,and the related data were statistically analyzed.Results The rebleeding group had more hematoma volume,application of anticoagulant drugs and brain herniation than the non-rebleeding group,and the GCS score at admission was lower than that of the non-rebleeding group(P<0.05).Serum FA,betatrophin,YKL-40 were higher than those in the non-rebleeding group(P<0.05).The difference between hematoma volume,application of anticoagulants,cerebral hernia,GCS score at admission,serum FA,betatrophin and YKL-40 surgery were all related to postoperative rebleeding(P<0.05).The areas under the receiver operating characteristic curve of serum FA,betatrophin and YKL-40 predicted rebleeding were 0.748,0.779 and 0.788,respectively.The area of combination of the three was 0.938;the risk of rebleeding when the difference between serum FA,betatrophin and YKL-40 before and after operation was greater than or equal to the corresponding optimal cut-off value were 4.412,7.464,and 6.033 times less than the corresponding cut-off value,respectively.Conclusion Serum FA,betatrophin and YKL-40 are related to rebleeding after neuroendoscopy in hypertensive deep intracerebral hemorrhage.Monitoring the changes of each index before operation and immediately after operation can help predict the risk of postoperative rebleeding in patients,which is the clinical treatment provide refer

关 键 词：胎球蛋白 betatrophin 甲壳质酶蛋白-40 高血压深部脑出血 神经内镜术 再出血 

分 类 号：R743[医药卫生—神经病学与精神病学]