脑肠肽Ghrelin和ICAM-1表达与基底节脑出血患者神经功能缺损及预后的关系

The relationships between the expression of Ghrelin,ICAM-1 and the neurological deficit,prognosis in patients with basal ganglia intracerebral hemorrhage

目的检测基底节脑出血患者血清脑肠肽Ghrelin和细胞间粘附分子-1(ICAM-1)的表达情况,并探讨其表达水平与基底节脑出血患者神经功能缺损及预后的相关性。方法选取2016年1月~2018年2月潍坊医学院附属医院确诊并住院治疗的80例基底节区脑出血患者为基底节脑出血组,并选取同期在该院神经内科进行常规检查的人群75例为对照组。采用酶联免疫吸附(ELISA)法检测两组血清脑肠肽Ghrelin和ICAM-1表达水平;采用脑卒中神经功能缺损评分表(CSS)分析患者神经功能缺损情况;根据Rankin量表(MRS)对患者进行MRS评分,分析患者预后不良情况发生率。结果基底节脑出血组血清脑肠肽Ghrelin表达水平显著低于对照组,ICAM-1表达水平显著高于对照组(均P<0.05);高Ghrelin者CSS评分显著低于低Ghrelin者,高ICAM-1者CSS评分显著高于低ICAM-1者(均P<0.05);高Ghrelin者预后不良发生率明显低于低Ghrelin者,高ICAM-1者预后不良发生率明显高于低ICAM-1者(均P<0.05);Logistic分析显示,血清Ghrelin表达水平为基底节脑出血患者发生死亡或残疾的保护因素,血清ICAM-1表达水平是影响基底节脑出血患者发生死亡或残疾的独立危险因素。结论脑肠肽Ghrelin在基底节脑出血患者中的表达水平明显降低,ICAM-1表达水平明显升高,两者参与基底节脑出血的发生及发展,且其表达情况与患者神经功能缺损及预后密切相关,提示脑肠肽Ghrelin和ICAM-1可作为基底节脑出血预后评估的潜在生物学指标。

Objective To detect the expression of Ghrelin and intercellular adhesion molecule-1(ICAM-1)in serum of patients with basal ganglia intracerebral hemorrhage,and explore the correlations between their expression levels and the neurological deficit,prognosis of patients with basal ganglia intracerebral hemorrhage.Methods From January 2016 to February 2018,80 patients with basal ganglia intracerebral hemorrhage diagnosed and hospitalized in Department of Neurology of our hospital were selected as the basal ganglia intracerebral hemorrhage group,and 75 patients underwent routine examination in Department of Neurology of our hospital were selected as the control group.The expression levels of Ghrelin and ICAM-1 in serum were detected by enzyme-linked immunosorbent assay(ELISA).The neurological deficit was analyzed by Chinese Stroke Scale(CSS).The patients were evaluated by MRS according to the Rankin Scale(MRS),and the incidence of poor prognosis was analyzed.Results The expression level of serum Ghrelin in basal ganglia intracerebral hemorrhage group was significantly lower than that in control group(P<0.05),and the expression level of ICAM-1 was significantly higher than that in control group(P<0.05).The CSS score of high Ghrelin group was significantly lower than that of low Ghrelin group(P<0.05),and the CSS score of high ICAM-1 group was significantly higher than that of low ICAM-1 group(P<0.05).The incidence of poor prognosis in high Ghrelin group was significantly lower than that in low Ghrelin group(P<0.05),and that in high ICAM-1 group was significantly higher than that in low ICAM-1 group(P<0.05).Logistic analysis showed that the expression level of serum Ghrelin was the protective factor of death or disability in patients with basal ganglia intracerebral hemorrhage,and the expression level of serum ICAM-1 was the independent risk factor of death or disability in patients with basal ganglia intracerebral hemorrhage.Conclusion The expression of Ghrelin in patients with basal ganglia cerebral hemorrhage is significantly decreased,and the expression level of ICAM-1 is significantly increased.Both of them are involved in the occurrence and development of basal ganglia cerebral hemorrhage,and their expressions are closely related to the neurological deficit and prognosis of patients.It is suggested that Ghrelin and ICAM-1 can be used as potential biological indexes for prognosis of basal ganglia intracerebral hemorrhage.