血清PTX3、Nogo-A对动脉瘤蛛网膜下腔出血病人介入治疗预后的预测价值  

Predictive value of serum PTX3 and Nogo-A for the prognosis of interventional therapy for patients with aneurysm subarachnoid hemorrhage

作　　者：周坦 宋会双 张换立 刘炜 李静 ZHOU Tan;SONG Huishuang;ZHANG Huanli;LIU Wei;LI Jing(Department of Neurosurgery,Hebei Petro China Central Hospital,Langfang,Hebei 065000,China)

机构地区：[1]河北中石油中心医院神经外科,河北廊坊065000

出　　处：《安徽医药》2025年第4期683-687,共5页Anhui Medical and Pharmaceutical Journal

基　　金：廊坊市科技支撑项目(2019013015)。

摘　　要：目的通过检测血清正五聚蛋白3(PTX3)和轴突生长抑制因子A(Nogo-A)的表达水平,来探讨PTX3、Nogo-A对动脉瘤蛛网膜下腔出血(aSAH)病人介入治疗预后的预测价值。方法收集2020年1月至2021年12月在河北中石油中心医院接受血管内介入治疗的aSAH病人108例作为研究对象,根据随访结果,依据格拉斯哥预后评分(GOS)将其分为预后良好组(72例)和预后不良组(36例)。通过酶联免疫吸附分析(ELISA)检测各组血清PTX3、Nogo-A的表达水平;使用Spearman法分析血清PTX3、Nogo-A水平与GOS评分的相关性;采用logistic多因素回归分析与aSAH病人介入治疗后预后状况有关的影响因素;绘制受试者操作特征曲线(ROC曲线)观察血清PTX3、Nogo-A水平对aSAH病人介入治疗预后的预测价值。结果预后不良组血清PTX3(2.54±0.76)μg/L、Nogo-A(170.15±19.18)μg/L的表达水平均高于预后良好组血清PTX3(1.49±0.38)μg/L、Nogo-A(135.64±16.12)μg/L水平(P<0.05)。Spearman相关性分析结果显示,aSAH病人血清中PTX3、Nogo-A表达水平与GOS评分呈负相关(rs=−0.62、−0.62,均P<0.05)。logistic回归分析结果显示,Hunt-Hess分级、改良Fisher分级、血清PTX3、Nogo-A均是aSAH病人介入治疗预后不良的独立危险因素(P<0.05)。ROC曲线结果发现,血清PTX3、Nogo-A预测aSAH病人介入治疗预后的最佳截断值分别为1.90μg/L、147.83μg/L,曲线下面积(AUC)分别为0.86、0.90,当二者联合时其AUC为0.95,高于两者单独检测(P<0.05)。结论aSAH病人血清中PTX3、Nogo-A表达水平异常升高,二者联合检测对aSAH病人预后不良具有较高的预测价值。Objective To detect the expression levels of serum pentraxin 3(PTX3)and axon growth inhibitory factor A(Nogo-A),and to explore the predictive value of PTX3 and Nogo-A for the prognosis of patients with aneurysm subarachnoid hemorrhage(aSAH)after interventional therapy.Methods From January 2020 to December 2021,108 aSAH patients who received endovascular interventional therapy in Hebei Petro China Central Hospital were collected as research subjects.The patients were followed up for half a year after treatment.According to the Glasgow Outcome Scale(GOS),108 patients were grouped into a good prognosis group(72 cases)and a poor prognosis group(36 cases).Enzyme-linked immunosorbent assay(ELISA)was performed to detect the expression levels of serum PTX3 and Nogo-A in each group;Spearman correlation analysis was performed to analyze the correlation between serum PTX3 and Nogo-A levels and GOS score;logistic regression was performed to analyze the factors influencing the interventional therapy prognosis in aSAH patients;ROC curves were drawn to observe the predictive value of serum PTX3 and Nogo-A levels for the prognosis of aSAH patients undergoing interventional therapy.Results The expression levels of serum PTX3(2.54±0.76)μg/L and Nogo-A(170.15±19.18)μg/L in the poor prognosis group were higher than those in the good prognosis group PTX3(1.49±0.38)μg/L and Nogo-A(135.64±16.12)μg/L(P<0.05).The results of Spearman correlation analysis showed that the expression levels of PTX3 and Nogo-A in the serum of aSAH patients were negatively correlated with the GOS score(rs=−0.62,−0.62,P<0.05).Logistic regression analysis showed that Hunt-Hess grade,modified Fisher grade,serum PTX3 and Nogo-A were independent risk factors of poor prognosis of aSAH patients after interventional therapy(P<0.05).The results of the ROC curve showed that the best cut-off values of serum PTX3 and Nogo-A for predicting the prognosis of aSAH patients after interventional therapy were 1.90μg/L and 147.83μg/L,respectively,and the areas under

关 键 词：蛛网膜下腔出血 颅内动脉瘤 正五聚蛋白3 轴突生长抑制因子A 介入治疗 预后价值 

分 类 号：R743.35[医药卫生—神经病学与精神病学]