摘要
目的 探讨脑脊液中趋化因子、白细胞介素水平对重症急性脑出血(ICH)预后的预测价值.方法 回顾性选取医院2023年6月-2024年1月收治的47例急性ICH患者为研究对象,根据ICH患者疗效情况分为好转组(n=19)和未好转组(n=28).入院后患者均接受急诊手术治疗,检测并比较两组患者治疗前后脑脊液趋化因子(CCL3、CCL17、CXCL12)和白细胞介素(IL-1β、IL-2、IL-6)水平.结果 好转组患者治疗后CCL3、CCL17、CXCL12水平表达低于治疗前,未好转组治疗后CCL3、CCL17、CXCL12水平表达高于治疗前,且好转组治疗后CCL3、CCL17、CXCL12水平表达低于未好转组治疗后(P＜0.05).好转组患者治疗后的IL-1 β、IL-2、IL-6水平表达低于治疗前,未好转组患者的IL-2、IL-6水平表达高于治疗前,并且好转组治疗后IL-1 β、IL-2、IL-6水平表达低于未好转组,差异均有统计学意义(P＜0.05);ROC曲线显示,CCL3、CCL17、CXCL12、IL-1β、IL-2、IL-6应用于重症急性ICH预后预测的AUC均大于0.50(P＜0.05),表明各项指标均具有预测效能,其中IL-2的预测效果相对较好.结论 脑脊液中趋化因子、白细胞介素水平与重症急性ICH预后具有一定的相关性,可作为预测ICH患者预后指标.
Abstract
Objective To explore the predictive value of chemokines and interleukin levels in cerebrospinal fluid for the prognosis of severe acute cerebral hemorrhage(ICH).Methods A retrospective study was conducted on 47 patients with acute ICH admitted to the hospital from June 2023 to January 2024.According to the efficacy of ICH patients,they were divided into an improvement group(n=1 9)and a non improvement group(n=28).After admission,all patients underwent emergency surgical treatment.The levels of chemokines(CCL3,CCL17,CXCL12)and interleukins(IL-1 β,IL-2,IL-6)in cerebrospinal fluid were measured and compared between the two groups before and after treatment.Results The expression levels of CCL3,CCL17,and CXCL12 in the improved group were lower than before treatment,while the expression levels of CCL3,CCL17,and CXCL12 in the non improved group were higher than before treatment,and the expression levels of CCL3,CCL17,and CXCL12 in the improved group were lower than those in the non improved group after treatment(P＜0.05).The expression levels of IL-1 β,IL-2,and IL-6 in the improved group were lower than before treatment,while the expression levels of IL-2 and IL-6 in the non improved group were higher than before treatment.Moreover,the expression levels of IL-1β,IL-2,and IL-6 in the improved group were lower than those in the non improved group after treatment,and the differences were statistically significant(P＜0.05)).The ROC curve shows that the AUC of CCL3,CCL17,CXCL12,IL-1 β,IL-2,and IL-6 used for predicting the prognosis of severe acute ICH were all greater than 0.50(P＜0.05),indicating that all indicators had predictive power,with IL-2 having a relatively good predictive effect.Conclusion The levels of chemokines and interleukins in cerebrospinal fluid are correlated with the prognosis of severe acute ICH and can be used as prognostic indicators for ICH patients.
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