自发性脑出血患者血清CXCL1、CXCR2表达水平及临床意义

Expression levels and clinical significance of CXCL1 and CXCR2 in serum of patients with spontaneous intracerebral hemorrhage

目的探讨CXC趋化因子配体1(CXCL1)、趋化因子受体2(CXCR2)在自发性脑出血(SICH)患者血清中的表达水平及临床意义。方法选取2019年5月—2020年10月达州市中心医院脑血管病科和神经内科收治的SICH患者125例为研究对象,同期选取医院体检健康者130例为健康对照组。收集患者一般资料,酶联免疫吸附(ELISA)法检测所有受试者血清CXCL1、CXCR2水平。对SICH患者出院90 d后进行随访,并根据改良Rankin量表(mRS)评分将患者分为预后不良亚组47例,预后良好亚组78例。Logistic回归分析影响SICH患者预后不良的危险因素;受试者工作特征曲线(ROC)分析血清CXCL1、CXCR2水平对SICH患者预后不良的预测价值。结果与健康对照组比较,SICH组血清CXCL1、CXCR2水平显著升高(t/P=34.105/0.000、27.349/0.000)。随着神经功能缺损程度和脑出血量的增加,SICH患者血清CXCL1、CXCR2水平依次升高(CXCL1:F/P=112.201/0.000、135.823/0.000;CXCR2:F/P=48.927/0.000、52.139/0.000);预后不良亚组SICH患者血清CXCL1、CXCR2水平显著高于预后良好亚组(t/P=13.072/0.000、9.350/0.000)。SICH患者血清CXCL1与CXCR2水平呈正相关(r/P=0.714/0.000)。Logistic多因素回归分析结果表明,脑出血量大及血清CXCL1、CXCR2升高是SICH患者预后不良的危险因素(P<0.05)。血清CXCL1、CXCR2水平预测SICH预后不良的曲线下面积(AUC)分别为0.712(95%CI 0.610~0.815)、0.714(95%CI 0.619~0.809),二者联合预测SICH预后不良的AUC为0.823(95%CI 0.718~0.917),优于单独预测。结论血清CXCL1、CXCR2水平与SICH患者神经功能缺损程度、脑出血量及预后有关,可能是临床上预测SICH预后的潜在生物标志物。

Objective To investigate the expression levels and clinical significance of CXC chemokine ligand 1(CXCL1)and CXC chemokine receptor 2(CXCR2)in serum of patients with spontaneous intracerebral hemorrhage(SICH).Methods 125 patients with SICH in department of cerebrovascular disease and department of neurology Dazhou Central Hospital from May 2019 to October 2020 were selected as the research objects,and 130 healthy people in our hospital were selected as the control group.The general data of the patients were collected,and the levels of serum CXCL1 and CXCR2 was detected by enzyme-linked immunosorbent assay(ELISA).The patients were followed up 90 days after discharge and divided into poor prognosis subgroup(47 cases)and good prognosis subgroup(78 cases)according to modified Rankin scale(mRS)score.Logistic regression analysis was used to analyze the risk factors of poor prognosis in SICH patients;receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum CXCL1 and CXCR2 levels for poor prognosis in patients with SICH.Results Compared with the control group,the levels of serum CXCL1 and CXCR2 in SICH group was significantly increased(t/P=34.105/0.000,27.349/0.000).The levels of serum CXCL1 and CXCR2 in SICH patients increased significantly with the increases of neurological deficit and cerebral hemorrhage(t/P=6.219/0.000,4.766/0.000,9.460/0.000,5.529/0.000,7.679/0.000,5.622/0.000,8.973/0.000,4.544/0.000);the levels of serum CXCL1 and CXCR2 in poor prognosis subgroup were significantly higher than those in good prognosis subgroup(t/P=13.072/0.000,9.350/0.000).The expression of serum CXCL1 and CXCR2 was positively correlated in SICH patients(r/P=0.714/0.000).Logistic regression analysis showed that cerebral hemorrhage volume,serum CXCL1 and CXCR2 were risk factors for poor prognosis of SICH patients(P<0.05).The area under the curve(AUC)of serum CXCL1 and CXCR2 levels in predicting poor prognosis of SICH was 0.712(95%CI:0.610~0.815)and 0.714(95%CI:0.619~0.809),respectively,the AUC of combining CXCL1 and CXCR2 levels in predicting poor prognosis of SICH was 0.823(95%CI:0.718~0.917),which was better than that of single prediction of poor prognosis of SICH.Conclusion The expression of CXCL1 and CXCR2 in serum of SICH patients related to the degree of neurological deficit,the amount of cerebral hemorrhage and prognosis,which may be potential biomarkers to predict the prognosis of SICH.