血浆Cor NSE胰岛素抵抗与高血压性脑出血患者预后的关系

Correlation Between Plasma Cor NSE Insulin Resistance and Prognosis of Patients with Hypertensive Cerebral Hemorrhage

目的:探讨血浆皮质醇(Cor)、神经元特异性烯醇化酶(NSE)、胰岛素抵抗与高血压性脑出血患者预后的关系。方法:选取106例高血压性脑出血患者,根据预后分为存活组88例和死亡组18例;根据神经功能缺损程度分为轻度组70例、中度组26例和重度组10例。选取50例中老年健康体检者为健康对照组。确诊后24h内检验血浆Cor、NSE、空腹血糖、空腹胰岛素水平,计算胰岛素抵抗指数。结果:脑出血组患者的Cor、NSE水平和胰岛素抵抗指数均高于健康对照组(P<0.05)。中度组与重度组的Cor水平高于轻度组(P<0.05);重度组的NSE水平高于轻度组与中度组(P<0.05);中度组与重度组的胰岛素抵抗指数高于轻度组(P<0.05)。Cor、NSE水平和胰岛素抵抗指数与NIHSS评分均呈正相关(r=0.325,r=0.530,r=0.336,P<0.05)。死亡组的Cor、NSE水平和胰岛素抵抗指数均高于存活组(P<0.05)。Cor水平升高(β=0.853,OR=2.347,95%CI=1.286~4.283)、NSE水平升高(β=0.469,OR=1.598,95%CI=1.258~2.030)、胰岛素抵抗指数升高(β=0.543,OR=1.721,95%CI=1.112~2.665)与预后不良有正的关联。结论:高血压性脑出血患者的血浆Cor、NSE水平和胰岛素抵抗情况与病情严重程度和预后密切相关。

Objective:To explore the correlation between plasma Cortisol(Cor),neuron-specific enolase(NSE),insulin resistance(IR)and prognosis of patients with hypertensive cerebral hemorrhage(HCH).Methods:A total of 106 HCH patients were enrolled and divided into survival group(88 cases)and death group(18 cases)according to their prognosis.According to neurological deficit degree,they were divided into mild group(70 cases),moderate group(26 cases)and severe group(10 cases).Fifty middle-aged and elderly health controls in the same period were enrolled as control group.The levels of plasma Cor,NSE,fasting blood glucose(FBG)and fasting insulin were detected within 24h after confirming.IR index was calculated.Results:The levels of Cor and NSE,and IR index in cerebral hemorrhage group were higher than those in control group(P<0.05).Cor level in moderate group and severe group was higher than that in mild group(P<0.05).NSE level in severe group was higher than that in mild group and moderate group(P<0.05).IR index in moderate group and severe group was higher than that in mild group(P<0.05).The levels of Cor and NSE,and IR index were positively correlated with NIHSS score(r=0.325,r=0.530,r=0.336,P<0.05).The levels of Cor and NSE,and IR index in death group were higher than those in survival group(P<0.05).The high-level Cor(β=0.853,OR=2.347,95%CI=1.286-4.283),high-level NSE(β=0.469,OR=1.598,95%CI=1.258-2.030)and increased IR index(β=0.543,OR=1.721,95%CI=1.112-2.665)were positively correlated with unfavorable prognosis.Conclusion:The levels of plasma Cor and NSE,and IR are closely related to disease severity and prognosis of HCH patients.