自发性脑出血患者血清SIRT3、Apo-J水平及与早期神经功能恶化的关系  

Serum SIRT3 and Apo-J levels in patients with spontaneous intracerebral hemorrhage and the relationship with early neurological deterioration

作　　者：王静云 郑玮 王亚男 李冰 Wang Jingyun;Zheng Wei;Wang Yanan;Li Bing(Department of Neurology,Qingdao Jiaozhou Central Hospital,Shandong,Qingdao 266300,China;不详)

机构地区：[1]山东省青岛市胶州中心医院神经内科,266300 [2]山东省青岛市胶州中心医院EICU,266300

出　　处：《疑难病杂志》2025年第4期439-444,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：山东省医药卫生科技发展计划项目(20204010124)。

摘　　要：目的探讨自发性脑出血(sICH)患者血清沉默信息调节因子3(SIRT3)、载脂蛋白J(Apo-J)水平及其与早期神经功能恶化(END)的关系。方法选取2020年1月—2024年8月青岛市胶州中心医院神经内科收治的sICH患者303例为ICH组,同期医院健康体检志愿者155例为健康对照组。根据神经功能缺损程度将sICH患者分为轻度缺损亚组102例[美国国立卫生研究院卒中量表(NIHSS)评分≤4分]、中度缺损亚组121例(NIHSS评分5~20分)、重度缺损亚组80例(NIHSS评分>20分);根据是否发生END将sICH患者分为END亚组60例和非END亚组243例。采用酶联免疫吸附法检测血清SIRT3、Apo-J水平;采用Spearman相关性分析sICH患者血清SIRT3、Apo-J水平与NIHSS评分的相关性;多因素Logistic回归分析血清SIRT3、Apo-J水平与sICH患者END的关系;受试者工作特征(ROC)曲线分析血清SIRT3、Apo-J水平对sICH患者END的预测效能。结果与健康对照组比较,sICH组血清SIRT3水平降低,Apo-J水平升高(t/P=26.232/<0.001、30.021/<0.001);轻度缺损亚组、中度缺损亚组、重度缺损亚组血清SIRT3水平依次降低,Apo-J水平依次升高(F/P=805.445/<0.001、550.374/<0.001)。sICH患者NIHSS评分与血清SIRT3水平呈负相关(r_(s)/P=-0.809/<0.001),与Apo-J水平呈正相关(r_(s)/P=0.792/<0.001)。303例sICH患者END发生率为19.80%(60/303),与非END亚组比较,END亚组血清SIRT3水平降低,Apo-J水平升高(t/P=8.539/<0.001、7.972/<0.001)。血肿体积大、基线NIHSS评分高、Apo-J高为sICH患者END的独立危险因素[OR(95%CI)=1.143(1.072~1.218)、1.091(1.036~1.148)、1.079(1.046~1.114)],基线GCS评分高、SIRT3高为独立保护因素[OR(95%CI)=0.726(0.620~0.850)、0.469(0.339~0.650)]。血清SIRT3、Apo-J水平及二者联合预测sICH患者发生END的曲线下面积(AUC)为0.790、0.786、0.891,二者联合的AUC大于血清SIRT3、Apo-J水平单独预测(Z/P=4.079/<0.001、4.086/<0.001)。结论sICH患者血清SIRT3水平降低,Apo-J水平升高,与�Objective To investigate the levels of serum sirtuin 3(SIRT3)and apolipoprotein J(Apo-J)in patients with spontaneous intracerebral hemorrhage(sICH)and their relationship with early neurological deterioration(END).Met-hods A retrospective study was conducted on 303 sICH patients(ICH group)admitted to the Neurology Department of Jiaozhou Central Hospital,Qingdao,from January 2020 to August 2024,and 155 healthy volunteers(control group)from the same hospital.Based on neurological deficit severity,sICH patients were classified into mild deficit subgroup(102 cases,NIHSS score≤4),moderate deficit subgroup(121 cases,NIHSS score 5-20),and severe deficit subgroup(80 cases,NIHSS score>20).Patients were further divided into END subgroup(60 cases)and non-END subgroup(243 cases)based on the occurrence of END.Serum SIRT3 and Apo-J levels were measured by enzyme-linked immunosorbent assay(ELISA).Spearman correlation analysis was performed to examine the relationship between serum SIRT3 and Apo-J levels and NIHSS scores in sICH patients.Multivariate unconditional logistic regression was used to analyze the association of serum SIRT3 and Apo-J levels with END in sICH patients,and the predictive efficacy of serum SIRT3 and Apo-J levels for END was assessed using ROC curves.Results Compared to the control group,serum SIRT3 levels were decreased and Apo-J levels were elevated in the sICH group(t/P=26.232/<0.001,30.021/<0.001).Serum SIRT3 levels progressively decreased,and Apo-J levels progressively increased across the mild,moderate,and severe deficit subgroups(F/P=805.445/<0.001,550.374/<0.001).NIHSS scores in sICH patients were negatively correlated with serum SIRT3 levels and positively correlated with Apo-J levels(r_(s)/P=-0.809/<0.001,0.792/<0.001).The incidence of END among the 303 sICH patients was 19.80%(60/303).Compared to the non-END subgroup,the END subgroup showed lower_(s)erum SIRT3 levels and higher Apo-J levels(t/P=8.539/<0.001,7.972/<0.001).Larger hematoma volume,higher baseline NIHSS scores,and elevated Apo-J were

关 键 词：自发性脑出血 沉默信息调节因子3 载脂蛋白J 神经功能缺损 早期神经功能恶化 

分 类 号：R743.34[医药卫生—神经病学与精神病学]