血清Adropin、CRP、MMP9水平与高血压脑出血患者病情严重程度及预后的关系

Relationship between serum Adropin,CRP,MMP9 and severity and prognosis of patients with hypertensive intracerebral hemorrhage

目的探讨血清Adropin、C-反应蛋白(CRP)、基质金属蛋白酶9(MMP9)水平与高血压脑出血患者病情严重程度及预后的相关性。方法选取2018年5月至2020年11月于首都医科大学附属北京友谊医院平谷医院住院治疗的高血压脑出血患者203例为研究组,选取同期该院健康体检者100例为对照组,利用酶联免疫吸附试验测定研究组入院12 h、1 d、3 d、7 d及对照组体检时血清Adropin、CRP、MMP9水平;比较研究组入院不同时间段和对照组,以及不同高血压分级、不同神经功能缺损程度、不同预后高血压脑出血患者入院12 h血清Adropin、CRP、MMP9水平;Logistic回归分析影响高血压脑出血患者预后不良的危险因素。结果研究组血清Adropin水平随入院时间增加逐渐降低且均低于对照组(P<0.05);研究组入院12 h、1 d、3 d血清CRP、MMP9水平逐渐升高(P<0.05),入院7 d血清CRP、MMP9水平有所下降,但均高于对照组(P<0.05)。Ⅰ级高血压组、Ⅱ级高血压组、Ⅲ级高血压组患者入院12 h血清Adropin水平逐渐降低,血清CRP、MMP9水平逐渐升高(F=13.810、42.396、249.849,P<0.05);轻度组、中度组、重度组患者入院12 h血清Adropin水平逐渐降低,血清CRP、MMP9水平逐渐升高(F=11.608、26.101、441.862,P<0.05);预后不良组患者入院12 h血清Adropin水平显著低于预后良好组,血清CRP、MMP9水平显著高于预后良好组(t=3.685、8.158、13.164,P<0.05);预后良好组和预后不良组高血压分级、神经功能缺损程度患者比例比较差异有统计学意义(χ^(2)=18.682、30.300,P<0.05);Logistic回归分析结果显示,入院12 h血清Adropin水平低、MMP9水平高、高血压分级Ⅲ级、重度神经功能缺损均为影响高血压脑出血患者预后不良的危险因素(P<0.05)。结论高血压脑出血患者血清Adropin、CRP、MMP9水平与患者病情严重程度存在一定关系,监测三者水平可为预测患者预后提供一定参考。

Objective To explore the correlations between the level of serum Adropin,C-reactive protein(CRP),matrix metalloproteinase 9(MMP9)and the severity and prognosis of hypertensive intracerebral hemorrhage.Methods A total of 203 patients with hypertensive intracerebral hemorrhage who were hospitalized in Pinggu hospital of Beijing Friendship Hospital affiliated to Capital Medical University from May 2018 to November 2020 were selected as the study group,and 100 healthy persons as the control group,the levels of serum Adropin,CRP and MMP9 were measured by enzyme linked immunosorbent assay in the study group at 12 hours,one day,three days and seven days after admission and the control group received physical examination;the levels of serum Adropin,CRP and MMP9 were compared between the study group at different time periods and the control group,as well as the patients with hypertensive intracerebral hemorrhage 12 hours after admission with different hypertension grades,different degrees of neurological impairment and different prognosis;Logistic regression analysis of risk factors for poor prognosis in patients with hypertensive intracerebral hemorrhage.Results The level of serum Adropin in the study group decreased with the increase of admission time(P<0.05),which was lower than that in the control group(P<0.05);the levels of serum CRP and MMP9 in the study group increased gradually at 12 hours,one day,three days(P<0.05),and decreased at seven days,but they were higher than those in the control group(P<0.05);at 12 hours after admission,the levels of serum Adropin in patients with grade I hypertension group,grade II hypertension group and gradeⅢhypertension group gradually decreased,while the levels of serum CRP and MMP9 gradually increased(F=13.810,42.396,249.849,P<0.05);the level of serum Adropin decreased gradually in the mild,medium and severe groups at 12 hours of admission,and the levels of serum CRP and MMP9 increased gradually(F=11.608,26.101,441.862,P<0.05);at 12 hours of admission,the level of serum Adropin in the poor prognosis group was significantly lower than that in the good prognosis group,and the levels of serum CRP and MMP9 in the poor prognosis group were significantly higher than those in the good prognosis group(t=3.685,8.158,13.164,P<0.05);there were significant differences in the proportion of patients with hypertension grade and neurological deficit between the good prognosis group and poor prognosis group(χ^(2)=18.682,30.300,P<0.05);Logistic regression analysis showed that low level of serum Adropin at 12 hours of admission,high level of MMP9,gradeⅢof hypertension and severe neurological deficit were risk factors for poor prognosis of patients with hypertensive intracerebral hemorrhage(P<0.05).Conclusion The serum levels of Adropin,CRP and MMP9 in patients with hypertensive intracerebral hemorrhage have a certain relationship with the severity of the disease.Monitoring the three levels can provide some reference for predicting the prognosis of patients.