Relationship between YKL-40,PON-1,and delayed cerebral edema after hematoma evacuation in hypertensive intracerebral hemorrhage patients
Objective To investigate the relationship between serum human cartilage glycoprotein-39(YKL-40),paraoxo-nase-1(PON-1),and the occurrence of delayed cerebral edema(DCE)after hematoma evacuation in patients with hyperten-sive intracerebral hemorrhage,aiming to provide a reference for clinical treatment.Methods A total of 122 patients with hypertensive intracerebral hemorrhage who underwent hematoma evacuation at the Eighth People's Hospital of Hefei from January 2021 to January 2024 were selected as the study group.According to the occurrence of DCE within 14 days post-sur-gery,the patients were assigned to the DCE group(n=42)and the non-DCE group(n=80).Additionally,138 healthy in-dividuals who underwent physical examinations at the same hospital during the same period were included as the control group.All study participants had their serum YKL-40 and PON-1 levels measured.General information for the patients in the study group was also collected.The receiver operating characteristic(ROC)curve was used to evaluate the value of ser-um YKL-40 and PON-1 in predicting DCE after hematoma evacuation.Multivariate regression was used to analyze the risk factors for DCE after surgery in patients with hypertensive intracerebral hemorrhage.Results The YKL-40 levels in the study group were significantly higher than those in the control group,while the PON-1 levels were significantly lower(P<0.05).In the DCE group,YKL-40 levels were significantly higher and PON-1 levels were significantly lower than those in the non-DCE group(P<0.05).The ROC curve results showed that the areas under the curve(AUC)for YKL-40 and PON-1 in assessing the occurrence of DCE in hypertensive intracerebral hemorrhage patients after hematoma evacuation were 0.801(95%CI:0.751-0.851)and 0.846(95%CI:0.796-0.896),respectively.The combined AUC for serum YKL-40 and PON-1 was 0.910(95%CI:0.860-0.960).Multivariate stepwise regression analysis revealed that the following factors were risk factors for DCE after hematoma evacuation in patients with hypertensive intracerebral hemorrhage:hyper-tension duration>5.2 years[OR(95%CI)=2.149(1.617-2.855)],National Institutes of Health Stroke Scale(NIH-SS)score>7[OR(95%CI)=1.900(1.464-2.466)],hematoma volume>45.0 m L[OR(95%CI)=3.360(1.952-5.783)],serum YKL-40>43.52 μg/L[OR(95%CI)=2.664(1.759-4.037)],and PON-1≤88.94 μg/m L[OR(95%CI)=3.916(2.079-7.375)](P<0.05).Conclusion In hypertensive intracerebral hemorrhage patients,serum YKL-40 levels are significantly elevated and PON-1 levels are significantly reduced.These changes are closely associated with the occurrence of DCE after hematoma evacuation.Serum YKL-40 and PON-1 may serve as potential biomarkers for the auxiliary assessment of DCE post-surgery.The combination of both biomarkers provides higher clinical value for evalua-ting the risk of DCE.
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