血清ALB、PA水平对高血压性脑出血患者神经内镜辅助下小骨窗手术预后的预测研究
Prediction of serum ALB and PA levels on the prognosis of neuroendoscopy-assisted small bone window surgery in patients with hypertensive cerebral hemorrhage
刘海丹 1郭蓉娟1
作者信息
- 1. 北京中医药大学东方医院脑病二科,北京 100078
- 折叠
摘要
目的 观察高血压性脑出血患者血清ALB、PA水平表达,分析其与患者神经内镜辅助下小骨窗手术预后情况之间的关系,以期为改善高血压性脑出血患者预后提供科学参考依据.方法 收集2019年1月至2021年1月北京中医药大学东方医院收治并随访的80例高血压性脑出血经神经内镜下小骨窗颅内血肿清除术治疗后预后不良患者的临床资料,纳入预后不良组,另采集同时期内在医院治疗并随访的80例高血压性脑出血神经内镜下小骨窗颅内血肿清除治疗预后良好的80例患者的临床资料,纳入预后良好组,随访日期至2021年4月;仔细查阅并记录患者基线资料及入院时血清PA、ALB水平,并分析二者与患者神经内镜辅助下小骨窗手术预后情况之间的关系.结果 预后不良组血清PA、ALB水平低于预后良好组,术前NIHSS评分、GCS评分低于预后良好组,改良Rankin量表评分高于预后良好组,差异有统计学意义(P＜0.05);二元Logistic回归分析,将全部自变量纳入建立多元回归模型行多元回归分析,结果显示,血清PA、ALB、改良Rankin量表评分、术前NIHSS评分、GCS异常可能是高血压性脑出血患者神经内镜辅助小骨窗颅内血肿清除术预后不良的风险因子(OR＞1,P＜0.05);绘制ROC曲线结果显示,高血压性脑出血患者入院时血清PA、ALB、PA+ALB分别预测高血压性脑出血患者神经内镜辅助小骨窗颅内血肿清除术预后不良风险的AUC均＞0.80,预测价值均较理想;采用双变量Spearman直线相关性分析,结果显示,高血压性脑出血患者血清PA、ALB水平与改良Rankin量表评分呈负相关(r=-0.593、-0.564,P＜0.05),血清ALB与血清PA呈正相关(r=0.634,P＜0.05).结论 高血压性脑出血患者入院时血清PA、ALB水平异常表达与患者神经内镜辅助下小骨窗颅内血肿清除术预后密切相关,对预测高血压性脑出血患者预后不良有一定价值,入院时血清PA高表达、ALB低表达可能提示患者预后不良风险.
Abstract
Objective To observe the expression of serum ALB and PA levels in patients with hypertensive cerebral hemorrhage and analyze the relationship between them and the prognosis of patients undergoing neuroendoscopic-assis-ted small bone window surgery,with the aim of providing a scientific reference basis for improving the prognosis of pa-tients with hypertensive cerebral hemorrhage.Methods Retrospective analysis was performed to collect the clinical da-ta of 80 patients with hypertensive cerebral haemorrhage treated with neuroendoscopic small bone window intracranial haematoma removal in Department of Brain Disease Ⅱ,Dongfang Hospital,Beijing University of Traditional Chinese Medicine Hospital from January 2019 to January 2021,who were successfully followed up,and were included in the poor prognosis group.The clinical data of 80 patients with good prognosis who were treated at the same period and suc-cessfully followed up at our hospital were collected and included in the good prognosis group until April 2021;the pa-tients'baseline data and serum PA and ALB levels at the time of admission were carefully reviewed and recorded,and the relationship between them and the prognosis of patients undergoing neuroendoscopic-assisted small bone window surgery was analysed.Results The poor prognosis group had lower serum PA and ALB levels than the good prognosis group,lower preoperative NIHSS scores and GCS scores than the good prognosis group,and higher modified Rankin Scale scores than the good prognosis group,with statistically significant differences(P＜0.05);binary logistic regres-sion analysis,followed by multiple regression analysis by including all independent variables in the establishment of a multiple regression model,showed that serum The results showed that serum PA,ALB,modified Rankin Scale score,preoperative NIHSS score,and abnormal GCS may be risk factors for poor prognosis of neuroendoscopic-assisted small bone window intracranial haematoma removal in patients with hypertensive cerebral haemorrhage(OR＞1,P＜0.05);the results of plotting ROC curves showed that serum PA,ALB,and PA+ALB at admission in patients with hyperten-sive cerebral haemorrhage were predictive of poor prognosis in patients with hypertensive cerebral haemorrhage,respec-tively.The AUC for neuroendoscopy-assisted small bone window intracranial hematoma removal in patients with cere-bral haemorrhage was＞0.80,and the predictive values were all satisfactory;using bivariate Spearman's linear correla-tion analysis,the results showed that serum PA and ALB levels were negatively correlated with modified Rankin Scale scores in patients with hypertensive cerebral haemorrhage(r=-0.593,-0.564,P＜0.05),and serum ALB was posi-tively correlated with serum PA(r=0.634,P＜0.05).Conclusion Abnormal expression of serum PA and ALB levels at admission in patients with hypertensive cerebral hemorrhage is closely related to the prognosis of patients with neu-roendoscopy-assisted small bone window intracranial hematoma removal,and has some value in predicting poor progno-sis in patients with hypertensive cerebral hemorrhage,and high expression of serum PA and low expression of ALB at admission may indicate the risk of poor prognosis in patients.
关键词
高血压性脑出血/血清前白蛋白/血清白蛋白/神经内镜/小骨窗颅内清除术/预后Key words
hypertensive cerebral haemorrhage/serum pre-albumin/serum albumin/neuroendoscopy/small bone window intracranial removal/prognosis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据