高血压深部脑出血神经内镜手术患者血清A-FABP、IL-1β、caveolin-1动态变化及预后预测价值

Dynamic Changes of Serum A-FABP,IL-1βand Caveolin-1 and Their Values in Prediction of prognoses of Patients with Deep Hypertensive Intracerebral Hemorrhage Undergoing Neuroendoscopic Surgery

目的探讨高血压深部脑出血神经内镜手术患者血清脂肪细胞型脂肪酸结合蛋白(A-FABP)、白细胞介素-1β(IL-1β)、小窝蛋白-1(caveolin-1)动态变化及预后预测价值。方法选取2018年5月—2021年4月收治的91例高血压深部脑出血,根据神经内镜手术后3个月预后情况分为不良组24例、良好组67例。比较两组术前和术后2周血清A-FABP、IL-1β、caveolin-1水平,应用Pearson相关性及偏相关性分析术后2周血清A-FABP、IL-1β、caveolin-1与术后3个月格拉斯哥预后量表(GOS)评分的关系,采用受试者工作特征(ROC)曲线分析术后2周A-FABP、IL-1β、caveolin-1预测预后的价值。结果不良组美国国立卫生研究院卒中量表评分、脑出血量>30 ml比例均高于良好组(P<0.05);术后2周,两组血清A-FABP、IL-1β、caveolin-1水平均低于术前,且不良组高于良好组(P<0.05)。术后2周血清A-FABP、IL-1β、caveolin-1与术后3个月GOS评分呈显著负相关(P<0.01);控制了混杂因素后,术后2周血清A-FABP、IL-1β、caveolin-1仍与术后3个月GOS评分相关(P<0.01)。术后2周血清A-FABP、IL-1β、caveolin-1联合预测预后的ROC曲线下面积最大,为0.915,敏感度为87.50%,特异度为85.07%。结论高血压深部脑出血神经内镜手术患者血清A-FABP、IL-1β、caveolin-1变化与预后有关,有望成为预测预后的有效指标。

Objective To investigate dynamic changes of serum adipocyte-type fatty acid-binding protein(A-FABP),interleukin-1β(IL-1β)and caveolin-1 in patients with deep hypertensive intracerebral hemorrhage(HIH)undergoing neuroendoscopic surgery and their value in prediction of prognosis.Methods A total of 91 patients with deep HIH admitted between May 2018 and April 2021 were selected and divided into poor prognosis group(n=24)and good prognosis group(n=67)according to prognosis conditions after neuroendoscopic surgery for 3 months.Serum levels of A-FABP,IL-1β and caveolin-1 were compared before and after operation for 2 weeks between the two groups,and Pearson correlation analysis and partial correlation analysis were used to analyze correlations between serum levels of A-FABP,IL-1β and caveolin-1 after operation for 2 weeks with Glasgow Outcome Scale(GOS)scores after operation for 3 months.The receiver operating characteristic(ROC)curve was used to analyze values of A-FABP,IL-1β and caveolin-1 after operation for 2 weeks in prediction of prognosis.Results National Institutes of Health Stroke Scale(NIHSS)score and proportion of cerebral hemorrhage more than 30 ml in poor prognosis group were significantly higher than those in good prognosis group(P<0.05).After operation for two weeks,serum levels of A-FABP,IL-1β and caveolin-1 were significantly lower than those before operation in two groups,and the levels in poor prognosis group were significantly higher than those in good prognosis group(P<0.05).Serum A-FABP,IL-1β and caveolin-1 after operation for 2 weeks were significantly negatively correlated with GOS score after operation for 3 months(P<0.01).After controlling for confounding factors,serum A-FABP,IL-1β and caveolin-1 after operation for 2 weeks were still correlated with GOS score after operation for 3 months(P<0.01).The area under the ROC curve of combination of serum A-FABP,IL-1β and caveolin-1 after operation for 2 weeks in prediction of prognosis was the largest(0.915),and its sensitivity and specificity were 87.50% and 85.07% respectively.Conclusion Changes of serum A-FABP,IL-1β and caveolin-1 in patients with deep HIH undergoing neuroendoscopic surgery are related to prognosis,which are expected to be effective indicators for predicting prognosis.