重症高血压性脑出血患者血清CCL23和STC1水平表达与预后的关系  

Relationship between Serum CCL23,STC1 Level Expression and Prognosis in Patients with Severe Hypertensive Intracerebral Hemorrhage

作　　者：陈波[1] 云亚滨 王伟志 杜俊峰[1] 范宏燕[1] CHEN Bo;YUN Yabin;WANG Weizhi;DU Junfeng;FAN Hongyan(Department of Neurosurgery,Hohhot First Hospital,Hohhot 010010,China)

机构地区：[1]呼和浩特市第一医院神经外科,呼和浩特010010

出　　处：《现代检验医学杂志》2025年第1期143-147,157,共6页Journal of Modern Laboratory Medicine

基　　金：呼和浩特市科研计划项目(项目编号:2013-社发-8)。

摘　　要：目的 探究重症高血压性脑出血(HICH)患者血清趋化因子配体23(CCL23)、斯钙素蛋白1(STC1)水平与临床结局的关系。方法 选取2021年3月~2023年3月于呼和浩特市第一医院神经外科就诊的重症HICH患者122例为研究对象(HICH组),同期轻症HICH患者122例为轻症组和体检健康者122例为健康组。HICH组根据预后情况分为生存组(n=94)和死亡组(n=28)。酶联免疫吸附法(ELISA)检测血清CCL23和STC1水平;Spearson法分析血清CCL23,STC1水平与GCS评分的相关性;多因素COX回归分析HICH患者预后的影响因素;ROC曲线分析血清CCL23,STC1水平对预后的预测价值;Kaplan-Meier分析血清CCL23,STC1水平与临床结局的关系。结果 健康组、轻症组和HICH组血清CCL23(53.32±10.85pg/ml,78.49±11.21pg/ml,112.47±11.53pg/ml),STC1(15.12±2.63ng/ml,19.07±2.58ng/ml,22.15±2.75ng/ml)水平依次升高,差异具有统计学意义(F=856.967,215.043,均P <0.05)。生存组血清CCL23(108.02±13.51pg/ml),STC1(21.06±3.28ng/ml)水平低于死亡组(127.41±13.55pg/ml,25.83±3.23ng/ml),格拉斯哥昏迷(GCS)评分(8.95±0.92分)高于死亡组(7.61±0.77分),差异具有统计学意义(t=6.663,6.810,7.005,均P <0.001)。血清CCL23,STC1水平与GCS评分呈负相关(r=-0.481,-0.426,P <0.001)。CCL23[OR(95%CI):1.240(1.091~1.409)],STC1[OR(95%CI):1.754(1.215~2.533)],GCS评分[OR(95%CI):0.087(0.020~0.382)]是HICH患者预后不良的影响因素(均P <0.05)。CCL23,STC1联合预测HICH患者预后的AUC(95%CI)为0.939(0.880~0.974),高于单独诊断(Z=1.974,2.040,P=0.048,0.041),联合诊断的敏感度和特异度分别为85.71%,94.68%。CCL23,SCT1高表达患者随访6个月生存率(51.06%,56.86%)低于CCL23,STC1低表达患者(93.33%,91.55%),差异具有统计学意义(Log rankχ^(2)=34.777,23.781,均P <0.05)。结论 重症HICH患者血清CCL23,STC1水平较高,与患者预后密切相关,CCL23,STC1高表达可能预示患者临床结局较差。Objective To investigate the relationship between serum C-C motif ligand 23(CCL23),Stanniocalcin-1(STC1)levels and prognosis in patients with severe hypertensive intracerebral hemorrhage(HICH).Methods A total of 122 severe HICH patients who visited the Department of Neurosurgery,Hohhot First Hospital from March 2021 to March 2023 were regarded as the study subjects(HICH group),122 patients with mild HICH during the same period(mild group)and 122 healthy individuals who underwent physical examinations were considered healthy.HICH patients were separated into survival group(n=94)and death group(n=28)based on prognosis.ELISA was applied to detect serum levels of CCL23 and STC1.Spearson on method was used to analyze correlations and multivariate COX regression was used to investigate the influencing factors of prognosis in HICH patients,and ROC curve was applied to analyze the predictive value of serum CCL23 and STC1 levels for the prognosis.Kaplan-Meier was applied to analyze the relationship between serum CCL23,STC1 levels and clinical outcomes.Results Serum CCL23(53.32±10.85pg/ml,78.49±11.21pg/ml,112.47±11.53pg/ml)and STC1(15.12±2.63ng/ml,19.07±2.58ng/ml,22.15±2.75ng/ml)levels in the healthy group,mild disease group and HICH group were increased successively,and the differences was statistically significant(F=856.967,215.043,all P<0.05).The serum levels of CCL23(108.02±13.51pg/ml)and STC1(21.06±3.28ng/ml)in the survival group were lower than those in the death group(127.41±13.55 pg/ml,25.83±3.23 ng/ml),the Glasgow coma(GCS)score(8.95±0.92)of the survival group was higher than that of the death group(7.61±0.77),and the differences were statistically significant(t=6.663,6.810,7.005,all P<0.001).The serum levels of CCL23 and STC1 were negatively correlated with GCS score(r=-0.481,-0.426,all P<0.001).CCL23[OR(95%CI):1.240(1.091~1.409)],STC[OR(95%CI):1.754(1.215~2.533)]and GCS[OR(95%CI):0.087(0.020~0.382)]score were the influencing factors for poor prognosis in HICH patients.The AUC(95%CI)of CCL23 combined

关 键 词：趋化因子配体23 斯钙素蛋白1 重症高血压性脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R392.11[医药卫生—临床医学]