动脉瘤性蛛网膜下腔出血患者血清HIF-1α、E-cadherin表达水平及与介入治疗预后的相关性  

Serum HIF-1αand E-cadherin expression levels in patients with aneurysmal subarachnoid hemorrhage and their correlation with prognosis of interventional therapy

作　　者：麦浩坚 张力 李华晓 刘裕浩 张猛[2] MAI Haojian;ZHANG Li;LI Huaxiao;LIU Yuhao;ZHANG Meng(Department of Brain Surgery,Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine,Shenzhen,Guangdong 518000,China;Department of Neurosurgery,Frist Affiliated Hospital of Shenzhen University,Shenzhen,Guangdong 518000,China)

机构地区：[1]深圳市中西医结合医院脑外科,广东深圳518000 [2]深圳大学第一附属医院神经外科,广东深圳518000

出　　处：《中华神经外科疾病研究杂志》2025年第1期59-63,共5页Chinese Journal of Neurosurgical Disease Research

基　　金：广东省卫生健康委员会科研课题(N20241667);深圳市科技计划项目(JCYJ20200109110420626)。

摘　　要：目的探讨动脉瘤性蛛网膜下腔出血(aSAH)患者血清缺氧诱导因子-1α(HIF-1α)、E-钙黏蛋白(E-cadherin)表达水平及与介入治疗预后的关系。方法选取2019年1月至2023年12月于深圳市中西医结合医院接受介入治疗的150例aSAH患者作为研究对象,随访90d并采用改良Rankin量表(mRS)评分评价患者介入治疗预后,将患者分为预后良好组(mRS评分0-2分,n=94)和预后不良组(mRS评分3-6分,n=56)。收集所有入组患者临床资料以及治疗前血清HIF-1α、E-cadherin表达水平。绘制受试者工作特征(ROC)曲线评价血清HIF-1α、E-cadherin对aSAH患者介入治疗预后的评估效能,应用二分类Logistic逐步回归分析探讨aSAH患者介入治疗预后的影响因素。结果预后不良组患者血清HIF-1α水平高于预后良好组,E-cadherin低于预后良好组(P<0.05)。血清HIF-1α、E-cadherin评估aSAH患者介入治疗预后的AUC(95%CI)分别为0.832(0.787-0.877)、0.769(0.719-0.819),两者联合评估的AUC(95%CI)为0.922(0.877-0.967)。预后不良组脑血管痉挛、改良Fisher分级为Ⅲ级、Hunt-Hess分级为Ⅲ级的患者占比及高血压史人数和GCS评分高于预后良好组(P<0.05)。多因素分析显示,脑血管痉挛(OR=2.050,95%CI:1.254-3.353),Hunt-Hess分级为Ⅲ级(OR=2.354,95%CI:1.346-4.115),血清HIF-1α≥127.33 pg/mL(OR=3.374,95%CI:1.659-6.859),血清E-cadherin≤168.26 ng/mL(OR=2.954,95%CI:1.624-5.370)是aSAH患者介入治疗预后的影响因素(P<0.05)。结论aSAH患者的血清HIF-1α和E-cadherin表达水平与介入治疗预后密切相关,可作为预后评估的参考指标。Objective To explore the relationship between serum hypoxia-inducing factor-1α(HIF-1α)and E-cadherin expression levels and prognosis after interventional therapy in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods A total of 150 patients with aSAH who received interventional therapy in our hospital from January 2019 to December 2023 were selected as the study objects.After 90 days of follow-up,the modified Rankin Scale(mRS)score was used to evaluate the prognosis of patients after interventional therapy,and good prognosis group(mRS Score 0-2,n=94)and poor prognosis group(mRS Score 3-6,n=56)were set up.Clinical data and serum HIF-1αand E-cadherin expression levels before treatment were collected from all of the enrolled patients.The efficacy of serum HIF-1αand E-cadherin in evaluating the prognosis of patients with aSAH after interventional therapy was evaluated by ROC,and the influencing factors of prognosis of patients with aSAH after interventional therapy were explored by binary Logistic step-up regression.Results The serum HIF-1αlevel in poor prognosis group was higher than the good prognosis group,and the E-cadherin level was lower than the good prognosis group(P<0.05).The AUC(95%CI)of serum HIF-1αand E-cadherin in evaluating the prognosis of aSAH cases after interventional therapy were 0.832(0.787-0.877)and 0.769(0.719-0.819),respectively.The combined AUC(95%CI)was 0.922(0.877-0.967).The proportion of patients with cerebral vasospasm,modified Fisher's gradeⅢ,Hunt Hess grade III,history of hypertension,and GCS score in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Multivariate analysis showed that cerebrovascular spasm(OR=2.050,95%CI:1.254-3.353),Hunt-Hess classification grade III(OR=2.354,95%CI:1.346-4.115),serum HIF-1α≥127.33 pg/mL(OR=3.374,95%CI:1.659-6.859),serum E-cadherin≤168.26 ng/mL(OR=2.954,95%CI:1.624-5.370)were the prognostic factors of aSAH patients after interventional therapy(P<0.05).Conclusions The expression levels of HIF-1αand

关 键 词：动脉瘤性蛛网膜下腔出血 缺氧诱导因子-1Α E-钙黏蛋白 介入治疗 

分 类 号：R743.35[医药卫生—神经病学与精神病学]