血清NSE、ET、MMP-9水平对高血压脑出血手术患者近期预后不良的预测分析  

Predictive analysis of serum NSE, ET and MMP-9 levels for poorshort-term prognosis in patients with hypertensive cerebralhemorrhage after surgery

作　　者：杨葵 张松鹤 陈科技 张亚军 YANG Kui;ZHANG Songhe;CHEN Keji;ZHANG Yajun(Department of Neurosurgery,Yongcheng People's Hospital,Shangqiu 476600,China)

机构地区：[1]永城市人民医院神经外科二病区,河南商丘476600

出　　处：《黑龙江医药科学》2025年第4期159-163,共5页Heilongjiang Medicine and Pharmacy

摘　　要：目的:探讨血清神经元特异性烯醇化酶(NSE)、内皮素(ET)、基质金属蛋白酶-9(MMP-9)预测高血压脑出血(HICH)手术患者近期预后不良的价值。方法:选取永城市人民医院2021年4月至2023年4月收治的228例拟行手术治疗的HICH患者,根据术后3个月患者预后情况将其分为预后良好组、预后不良组。比较两组患者血清NSE、ET、MMP-9水平;采用多因素Logistic回归分析法、受试者工作特征(ROC)曲线分别分析患者近期预后不良的影响因素以及血清NSE、ET、MMP-9的预测价值。结果:随访3个月,共脱落7例,余221例HICH手术患者近期预后不良发生率为31.67%。预后不良组血清NSE、ET、MMP-9高于预后良好组(P<0.05);多因素Logistic回归分析显示,格拉斯哥昏迷量表(GCS)评分、美国国立卫生院卒中量表(NIHSS)评分、发病至手术时间>6 h、血肿量大、出血破入脑室、D-二聚体、NSE、ET、MMP-9均是HICH手术患者近期预后不良危险因素(P<0.05);血清NSE、ET、MMP-9联合预测HICH手术患者近期预后不良的灵敏度95.71%高于单独预测,联合预测的曲线下面积(AUC)为0.958高于单独预测(P<0.05),联合预测的特异度86.09%与单独预测基本一致。结论:血清NSE、ET、MMP-9水平在HICH术后近期预后不良患者中均呈现高表达,均是预后不良影响因素,三者预测术后近期预后不良的价值较好。Objective:To investigate the value of serum neuron-specific enolase(NSE),endothelin(ET)and matrix metalloproteinase-9(MMP-9)in predicting poor prognosis in patients with hypertensive intracerebral hemorrhage(HICH).Methods:A total of 228 HICH patients who underwent surgical treatment in Yongcheng People's Hospital from April 2021 to April 2023 were selected.After 3 months of follow-up,They were divided into good prognosis group and poor prognosis group according to the prognosis of patients 3 months after surgery.The serum levels of NSE,ET and MMP-9 were compared between the two groups.Multivariate Logistic regression analysis,receiver operating characteristic(ROC)curve were used to analyze the influencing factors of poor prognosis and the predictive value of serum NSE,ET and MMP-9,respectively.Results:After 3 months of follow-up,7 cases were lost,and the incidence rate of poor short-term prognosis in 221 patients with HICH after surgery was 31.67%.The levels of serum NSE,ET and MMP-9 in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that Glasgow Coma Scale(GCS)score,National Institutes of Health Stroke Scale(NIHSS)score,time from onset to operation>6 h,large amount of hematoma,bleeding into ventricles,D-dimer,NSE,ET and MMP-9 were all risk factors for poor short-term prognosis in patients with HICH after surgery(P<0.05).The sensitivity of serum NSE,ET and MMP-9 combined prediction 95.71%of poor short-term prognosis in patients with HICH after surgery was higher than that of single prediction,and the area under the curve(AUC)of combined prediction(0.958)was higher than that of single prediction(P<0.05),and the specificity of the combined prediction 86.09%was basically consistent with the single prediction.Conclusion:The levels of serum NSE,ET and MMP-9 are highly expressed in patients with poor short-term prognosis after HICH,and all of them are adverse prognostic factors.The three has a good value in predicting poor short-term p

关 键 词：高血压脑出血 神经元特异性烯醇化酶 内皮素 基质金属蛋白酶-9 预后 预测价值 

分 类 号：R743.34[医药卫生—神经病学与精神病学]