高血压性脑出血患者血清S100β、NSE及Cor水平变化对病情、预后的影响

Effects of Changes in Serum S100β,NSE and Cor Levels on Conditions and Prognoses in Patients with Hypertensive Intracerebral Hemorrhage

目的探讨高血压性脑出血患者血清S100钙结合蛋白β(S100β)、神经元特异性烯醇化酶(NSE)及皮质醇(Cor)水平变化对病情、预后的影响。方法选取2017年6月—2019年4月收治的106例高血压性脑出血为观察组,根据入院后格拉斯哥昏迷量表(GCS)评分分为轻度组(12~15分)35例、中度组(9~11分)40例、重度组(3~8分)31例。另选取同期110例体检健康者为对照组。比较各组S100β、NSE、Cor水平变化,分析三者与GCS评分的相关性。采用多因素Logistic回归分析影响高血压性脑出血患者预后死亡相关因素。结果观察组S100β、NSE、Cor水平高于对照组(P<0.01)。轻度组S100β、NSE、Cor水平低于中度组及重度组,且中度组低于重度组(P<0.05)。高血压性脑出血患者S100β、NSE、Cor水平与GCS评分呈负相关(P<0.05)。S100β、NSE、Cor水平异常增高的高血压性脑出血患者病死率高于S100β、NSE、Cor正常患者(P<0.05,P<0.01)。合并意识障碍、GCS评分(3~8分)、S100β(异常增高)、NSE(异常增高)、Cor(异常增高)均为影响高血压性脑出血患者预后死亡的独立危险因素(P<0.05,P<0.01)。结论高血压性脑出血患者血清S100β、NSE、Cor水平呈异常升高状态,三者与病情严重程度密切相关,是影响患者预后死亡的独立危险因素。

Objective To explore the effects of changes in serum S100 calcium binding proteinβ(S100β),neuron-specific enolase(NSE)and cortisol(Cor)levels on conditions and prognoses in patients with hypertensive intracerebral hemorrhage(HIH).Methods A total of 106 patients with HIH admitted between June 2017 and April 2019 were selected as observation group,and the patients were divided into mild subgroup(12-15 points,n=35),moderate subgroup(9-11 points,n=40)and severe subgroup(3-8 points,n=31)according to Glasgow coma scale(GCS)scores of the patients after admission.In the meantime,other 110 healthy people undergoing physical examinations at the same period were selected as control group.Changes in S100β,NSE,and Cor levels were compared among group,and correlations between the three indicators with GCS score were analyzed.Multivariate Logistic regression analysis was used to analyze related factors affecting the prognoses and death of patients with HIH.Results Levels of S100β,NSE and Cor in observation group were significantly higher than those in control group(P<0.01).S100β,NSE,and Cor levels were the lowest in mild subgroup followed by moderate and severe subgroups(P<0.05).Levels of S100β,NSE and Cor were negatively correlated with GCS score in patients with HIH(P<0.05).The fatality rate of HIH patients with abnormally increased levels of S100β,NSE and Cor was significantly higher than that of patients with normal levels of S100β,NSE and Cor(P<0.05,P<0.01).Combined consciousness disorder,GCS score(3-8 points),abnormally increased S100β,abnormally increased NSE and abnormally increased Cor were independent risk factors affecting prognoses and death of patients with HIH(P<0.05,P<0.01).Conclusion Serum levels of S100β,NSE and Cor in patients with HIH are abnormally increased.The three indexes are closely related to the severity of the disease,and they are independent risk factors affecting the prognoses and death of patients.