血清烟酰胺腺嘌呤二核苷酸磷酸氧化酶2水平与动脉瘤性蛛网膜下腔出血病人脑组织血供及预后的相关性  

Correlation between serum nicotinamide adenine dinucleotide phosphate oxidase 2 level and cerebral blood supply and prognosis in patients with aneurysmal subarachnoid hemorrhage

作　　者：林锦超 郁毅刚[1] LIN Jinchao;YU Yigang(Department of Neurosurgery,The 909th Hospital,Dongnan Hospital of Xiamen University,Zhangzhou,Fujian 363000,China)

机构地区：[1]第九〇九医院(厦门大学附属东南医院)神经外科,福建漳州363000

出　　处：《临床外科杂志》2025年第2期134-138,共5页Journal of Clinical Surgery

摘　　要：目的 探讨血清烟酰胺腺嘌呤二核苷酸磷酸氧化酶2(nicotinamide adenine dinucleotide phosphate oxidase, NOX2)水平与动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage, aSAH)病人脑组织血供及预后的相关性。方法 2021年1月~2023年12月收治的150例aSAH病人作为观察组,同期选择65例本院健康体检者为对照组,经颅多普勒超声检测大脑中动脉(MCA)及大脑前动脉(ACA)的血流速度(Vm),检测病人及健康体检者血清NOX2的表达水平。Pearson相关性分析血清NOX2水平与MCA及ACA Vm血流速度的相关性。随访90天,将其分为预后良好组(98例)和预后不良组(52例);多因素Logistic回归分析aSAH病人预后不良的相关因素,绘制ROC曲线分析相关因素的预测效能。结果 观察组与对照组的血清NOX2分别为(2 185.20±231.15)pg/ml、(1 025.31±98.24)pg/ml, MCA的Vm分别为(64.30±8.22)cm/s、(89.16±9.14)cm/s, ACA的Vm分别为(39.20±3.04)cm/s、(51.03±9.35)cm/s,两组比较差异有统计学意义(P<0.05)。Pearson相关性分析显示,aSAH病人血清NOX2水平与MCA及ACA的Vm均呈负相关(r=-0.512/-0.219,P<0.05)。预后不良组与预后良好组的WBC分别为(9.96±2.76)×10^(9)/L、(8.35±2.51)×10^(9)/L,血糖水平分别为(8.16±2.05)mmol/L、(7.18±1.89)mmol/L,NOX2水平分别为(2 278.30±215.26)pg/ml、(1 985.36±221.34)pg/ml,改良Fisher评分分别为(3.02±0.98)分、(2.12±0.61)分,WFNS评分分别为(4.01±0.84)分、(2.16±0.72)分,急性脑积水占比分别为25.00%、9.18%,两组比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,NOX2水平(OR=1.008)和改良Fisher评分(OR=6.329)是aSAH病人预后不良的独立危险因素(P<0.05)。ROC曲线结果显示,NOX2水平、改良Fisher评分的曲线下面积(area under curve, AUC)分别为0.844(95%CI:0.776~0.898),0.691(95%CI:0.611~0.764)。结论 aSAH病人呈现较高血清NOX2水平,且与脑组织血供存在密切联系;血清NOX2水平和改良Fisher评分是aSAH病人预后不良的Objective To investigate the correlation between serum nicotinamide adenine dinucleotide phosphate oxidase 2(NOX2)level and cerebral blood supply and prognosis in patients with aneurysm al subarachnoid hemorrhage(aSAH).Methods 150 patients with aSAH admitted to our hospital from January 2021 to December 2023 were selected retrospectively as the observation group(150 cases),and 65 healthy people in our hospital were selected as the control group(65 cases)during the same period.Pearson correlation coefficient was used to analyze the correlation between serum NOX2 level and blood flow velocity of middle cerebral artery(MCA)and anterior cerebral artery(ACA).After 90 days of follow-up,according to the prognosis of aSAH patients,they were divided into good prognosis group(98 cases)and poor prognosis group(52 cases).Multivariate Logistic regression was used to analyze the related factors of poor prognosis in aSAH patients,and ROC curve was drawn to analyze the predictive efficacy of related factors.Results The serum NOX2 of the observation group and the control group were(2185.20±231.15)pg/ml and(1025.31±98.24)pg/ml,the Vm of MCA was(64.30±8.22)cm/s and(89.16±9.14)cm/s,and the Vm of ACA was(39.20±3.04)cm/s and(51.03±9.35)cm/s,respectively.The difference between the two groups was statistically significant(P<0.05).Pearson correlation coefficient analysis showed that the serum NOX2 level of aSAH patients was negatively correlated with the Vm of MCA and ACA(r=-0.512/-0.219,P<0.05).The WBC of the poor prognosis group and the good prognosis group were(9.96±2.76)×10^(9)/L and(8.35±2.51)×10^(9)/L,the blood sugar level was(8.16±2.05)mmol/L and(7.18±1.89)mmol/L,the NOX2 level was(2278.30±215.26)pg/ml and(1985.36±221.34)pg/ml,the improved Fisher score was(3.02±0.98)and(2.12±0.61),the WFNS score was(4.01±0.84)and(2.16±0.72),and the proportion of acute hydrocephalus was 25.00%and 9.18%,respectively.The difference between the two groups was statistically significant(P<0.05).Multivariate Logistic regression analysis

关 键 词：烟酰胺腺嘌呤二核苷酸磷酸氧化酶2 动脉瘤性蛛网膜下腔出血 预后 脑组织血供 

分 类 号：R74[医药卫生—神经病学与精神病学]