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血清基质金属蛋白酶-9、热休克蛋白47水平与急性脑出血术后预后的关系

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目的 采用血清基质金属蛋白酶-9(MMP-9)、热休克蛋白47(HSP47)水平与急性脑出血术后预后的关系.方法 2018年3月~2022年5月我院就诊急性脑出血病人145例,根据术后预后情况分为预后良好组(80例),预后不良组(65例).收集病人的一般资料,采集病人入院次日的清晨空腹外周血,酶联免疫吸附法检测血清MMP-9、HSP47水平,采用多因素Logistic回归分析急性脑出血术后预后不良的危险因素,采用受试者工作曲线(ROC曲线)分析急性脑出血术后病人血清MMP-9、HSP47水平对其短期预后的预测价值.结果 两组病人血肿形状是否规则、血肿量比较差异有统计学意义(P<0.05).术后预后不良组的血清MMP-9、HSP47水平高于预后良好组,差异有统计学意义(P<0.05).多因素Logistic回归显示,手术时间、血肿形状、血肿量、血清MMP-9、HSP47水平均是急性脑出血病人术后预后不良的危险因素(P<0.05),发病时间至手术时间>24小时、血肿形状不规则、血肿量多、血清MMP-9、HSP47水平越高的急性脑出血术后的病人,其发生预后不良的风险越大.ROC曲线分析表明,血清MMP-9、HSP47水平预测急性脑出血病人术后预后情况的AUC分别为0.718、0.827,灵敏度分别为81.5%、80.0%,特异度分别为50.0%、81.2%;两个指标联合预测的AUC为0.891,灵敏度为86.2%,特异度为85.0%.结论 急性脑出血术后预后不良病人的血清MMP-9、HSP47水平均升高,血肿形状不规则、血肿量、血清MMP-9、HSP47水平均是术后预后不良的危险因素.血清MMP-9、HSP47水平对急性脑出血术后的预后情况具有较高的预测价值,且联合预测的效能更高.
Analysis of correlation of serum matrix metalloproteinase-9 and heat shock protein-47 levels with prognosis in patients with acute cerebral hemorrhage
Objective To explore the correlation of serum matrix metalloproteinase-9(MMP-9)and heat shock protein-47(HSP-47)levels with prognosis in patients with acute cerebral hemorrhage.Methods One hundred and forty-five patients with acute cerebral hemorrhage attending our hospital from March 2018 to May 2022 were selected,and assigned into good prognosis group(n=80)and poor prognosis group(n=65)according to their postoperative prognosis.General information of patients was recorded.The early morning of the day after admission fasting peripheral venous blood samples were collected for the detection of serum MMP-9 and HSP47 levels.Multivariate Logistic regression analysis was conducted to screen the risk factors affecting poor prognosis in patients with acute cerebral hemorrhage,and the predictive value of serum MMP-9 and HSP47 levels on prognosis of patients with acute cerebral hemorrhage was evaluated by plotting ROC curve.Results Statistical difference was found in shape and volume of hematoma between two groups(P<0.05).Serum MMP-9 and HSP47 levels in poor prognosis group were higher than that in good prognosis group(P<0.05).Multivariate Logistic regression analysis denoted that duration of surgery,hematoma shape,hematoma volume,serum MMP-9 and HSP47 levels were all risk factors for poor prognosis in patients with acute cerebral hemorrhage(P<0.05).Patients with the time of onset to surgery>24 hours irregular shaped hematoma,large hematoma volume,and elevated serum levels of MMP-9 and HSP47 suffered a high risk of poor prognosis.ROC curve analysis demonstrated that AUC of serum MMP-9 and HSP47 levels for predicting the postoperative prognosis of patients with acute cerebral haemorrhage were 0.718 and 0.827,with a sensitivity of 81.5%and 80.0%,and a specificity of 50.0%and 81.2%,respectively.The AUC,sensitivity and specificity of combined detection of serum MMP-9 and HSP47 for prognosis prediction were 0.891,86.2%and 85.0%.Conclusion Serum MMP-9 and HSP47 levels are elevated in patients with poor prognosis after acute cerebral haemorrhage,and irregular shaped hematoma,hematoma volume,and serum MMP-9 and HSP47 levels are risk factors for poor prognosis after acute cerebral haemorrhage.Furthermore,serum MMP-9 and HSP47 are of great predictive value for the prognosis of patients with acute cerebral haemorrhage,and the predictive efficacy of combined detection of the two is better than that of separate test.

matrix metalloproteinase-9heat shock protein-47acute cerebral hemorrhageprognosisROC curve

王娜、孙伟伟、邢国靖、赵金雷、孙群

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255200 山东省淄博市第一医院急诊

山东省淄博市精神卫生中心男一病区

山东省淄博市中心医院超声医学科

淄川区妇幼保健计划生育服务中心妇女保健部

淄博市第一医院重症医学科

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基质金属蛋白酶-9 热休克蛋白47 急性脑出血 预后 ROC曲线

2024

临床外科杂志
中华医学会湖北分会

临床外科杂志

CSTPCD
影响因子:0.716
ISSN:1005-6483
年,卷(期):2024.32(8)