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投稿时间：2020-06-24 网络发布日期：2021-04-20
投稿时间：2020-06-24 网络发布日期：2021-04-20
中文摘要: 目的 探讨血清缺血修饰白蛋白(IMA)、中枢神经特异性蛋白(S100B)与动脉瘤性蛛网膜下腔出血(aSAH)患者病情的关系,及其对预后的评估价值。方法 选取2016年1月至2019年9月收治的191例aSAH患者为对象进行回顾性研究,根据术后6个月时Rankin量表(mRS)评分情况分为预后良好138例和预后不良53例。检测患者血清IMA、S100B水平,分析血清IMA、S100B水平与aSAH病理特征的关系,绘制ROC曲线分析IMA、S100B对aSAH患者预后的评估价值。结果 aSAH患者血清IMA、S100B水平与有无脑室积血、入院时Hunt-Hess分级、Fisher分级相关(P均<0.01),而与年龄、性别、动脉瘤部位、大小以及是否存在高血压史、糖尿病无关(P均>0.05)。预后良好患者的无脑室积血、Hunt-HessⅠ~Ⅱ级、FisherⅠ~Ⅱ级发生率均高于预后不良患者,血清IMA、S100B水平低于预后不良患者,差异均有统计学意义(P均<0.01)。IMA(最佳临界值为56.36 U/ml)、S100B(最佳临界值为0.84 ng/ml)联合检测评估aSAH预后的ROC曲线下面积（AUC）为0.942,敏感度为84.9%,特异度为92.8%。脑室积血、Hunt-Hess分级和Fisher分级高、血清IMA及S100B高水平是导致aSAH预后不良的独立危险因素(P<0.05,P<0.01)。结论 血清IMA及S100B水平与aSAH病情的严重程度有关,检测血清IMA、S100B水平有助于评估aSAH的预后状况。
中文关键词: 缺血修饰白蛋白 中枢神经特异性蛋白 蛛网膜下腔出血,动脉瘤性 预后
Abstract:Objective To investigate the associations of serum ischemia modified albumin (IMA) and central nerve specific protein (S100B) with the disease condition and the predictive values for prognosis in patients with aneurysmal subarachnoid hemorrhage (aSAH).
Methods A total of 191 patients with aSAH from January 2016 to September 2019 were selected for retrospective study.According to the modified Rankin scale (mRS) at 6 months after operation,the patients were divided into good prognosis group(n=138) and poor prognosis group(n=53).The serum levels of IMA and S100B were detected,and the associations of them with the pathological features of aSAH were analyzed.By drawing the receiver operating characteristic(ROC) curve,the prognostic value of IMA and S100B was analyzed in patients with aSAH.
Results The serum levels of IMA and S100B were statistically correlated to the presence or sbsence of ventricular hematocele,Hunt-Hess grading and Fisher grading scales at admission (all P<0.01),and were not associated to age,sex,aneurysm location and size,and history of hypertension or diabetes (all P>0.05).The incidence of non-ventricular hematocele,Hunt Hess grade Ⅰ-Ⅱ and Fisher grade Ⅰ-Ⅱ in patients with good prognosis were higher than those in patients with poor prognosis,while the serum IMA and S100B levels were significantly lower than those in patients with poor prognosis (all P<0.01).In evaluating the prognosis of aSAH by combined detection of IMA (optimal critical value=56.36 U/ml) and S100B (optimal critical value=0.84 ng/ml),the area under ROC curve(AUC) was 0.942,with a sensitivity of 84.9%,and a specificity of 92.8%.Ventricular hematocele,high Hunt-Hess grading,high Fisher grading and high serum IMA and S100B levels were the independent risk factors for poor prognosis of aSAH patients(P<0.05,P<0.01).
Conclusion Serum IMA and S100B levels are related to the severity of aSAH,and detection of them is helpful to evaluate the prognosis of aSAH patients.
keywords: Ischemia-modified albumin Central nerve specific protein Subarachnoid hemorrhage,aneurysmal Prognosis
文章编号： 中图分类号： 文献标志码：A
基金项目:河北省科技支撑计划项目(162777208)
| Author Name | Affiliation |
| ZHANG Dong-liang*,YANG Lei,XI Xue-feng,HAN Yong-feng,JIN Wen-cai,HE Pan | *Department of Neurosurgery,Shijiazhuang First Hospital,Shijiazhuang,Hebei 050000,China |
引用文本：
张栋梁,杨磊,习雪峰,等.血清IMA、S100B与动脉瘤性蛛网膜下腔出血患者病情及预后的相关性[J].中国临床研究,2021,34(4):455-459.
张栋梁,杨磊,习雪峰,等.血清IMA、S100B与动脉瘤性蛛网膜下腔出血患者病情及预后的相关性[J].中国临床研究,2021,34(4):455-459.