血清铁调素及铁代谢指标与脑出血早期病情及预后的相关性研究

Research on the serum hepcidin and iron metabolism indicator in intracerebral hemorrhage and its application in assessment of early conditions and prognosis

目的探讨脑出血患者血清铁调素及铁代谢指标的变化与脑出血神经功能缺损严重程度及预后的相关性。方法选取本院脑出血首发患者92例为观察组,92例健康体检者为对照组,检测发病后1、3、5、7及14 d两组血清铁调素(serum hepcidin,Hep)、血清铁蛋白(serum ferritin,SF)和白细胞介素-6(interleukin-6,IL-6)含量。观察组患者入院第3 d采用美国国立卫生研究院卒中量表评估病情严重程度,分为轻型、中型、重型3组;发病3月时采用改良Rankins’量表评估神经功能恢复情况,分为预后好组、预后差组。观察组根据CT资料计算入院时与入院第3 d的相对水肿体积系数。比较观察组与对照组各时间点Hep、SF、IL-6水平。分析Hep、SF、IL-6水平与神经功能缺损程度及预后的关系。结果观察组各时间点血清Hep、SF、IL-6水平均高于对照组,差异具有统计学意义(P<0.05,P<0.01);观察组轻、中、重型3组各时间点血清Hep、SF、IL-6水平两两比较,差异有统计学意义(P<0.01);观察组预后好组、预后差组各时间点血清Hep、SF、IL-6水平两两比较,差异有统计学意义(P<0.01)。观察组血清Hep水平与SF、IL-6水平及入院后第3 d相对水肿体积系数呈正相关(P<0.01)。结论血清Hep、SF、IL-6水平与脑出血的发生、病情严重程度、预后有密切关系,可作为判断ICH病情严重程度及预后的评价指标。

Objective To explore the relationship between serum hepcidin and iron metabolism indicator in intracerebral hemorrhage and its application in assessment of early conditions and prognosis.Methods According to the selection,92 patients were enrolled into an intracerebral hemorrhage(ICH)group and 92 healthy individuals into a control group.The levels of serum hepcidin(Hep)、serum ferritin(SF)、interleukin-6(IL-6)were measured at 1,3,5,7,14 days after onset of ICH.ICH group were further divided into a mild ICH group,a moderate ICH group,and a severe ICH group according to their NIHSS score on the third day of admission.The modified Rankin Scale(mRS)score was evaluated at 3 months after ICH.According to the mRS scores,the patients was divided into a good outcome group(mRS≤2)and a poor outcome group(mRS>2).In the observation group,the volume coefficient of relative edema at the time of admission and 3 days after admission was calculated according to the CT data.The levels of Hep、SF、IL-6 in the observation group and control group were compared at each time points.The relationship between the levels of Hep、SF、IL-6 and the neurologic impairment and prognosis were analyzed.Results The levels of serum Hep、SF、IL-6 at each time points in the observation group were higher than those inthe control group,which were statistical differences in them(P<0.05,P<0.01).There were statistical differences in the levels of serum Hep、SF、IL-6 at each time points among the mild,moderate and severe ICH groups(P<0.01).There were statistical differences in the levels of serum Hep、SF、IL-6 at each time points among the good outcome group and the poor outcome group(P<0.01).The serum level of Hep in the observation group was positively correlated with those of SF,IL-6 and the relative volume coefficient of edema on the third day after admission(P<0.01).Conclusions The levels of serum hepcidin、SF、IL-6 are closely related to the occurrence,severity and prognosis of ICH,which can be used as a bioindicator of the severity and prognosis of ICH.