乳酸、免疫球蛋白在脑出血并发脑心综合征中变化及意义

Changes and Significance of Lactic Acid and Immunoglobulin in Cerebral Hemorrhage Complicated by Cerebro-cardiac Syndrome

目的:分析乳酸、免疫球蛋白(Ig)在脑出血并发脑心综合征(CCS)中变化及意义。方法:回顾性分析本院2018年1月—2020年7月收治的85例脑出血合并CCS患者的临床资料(研究组)及同期选取50例健康体检志愿者(对照组)。比较两组血清乳酸、免疫球蛋白G(IgG)及免疫球蛋白M(IgM)水平,统计随访预后情况,对比其血清乳酸、IgG及IgM水平及影响脑出血合并CCS死亡的独立危险因素,绘制ROC曲线,分析不同指标对脑出血合并CCS死亡的预测价值。结果:研究组血清乳酸水平显著高于对照组,IgG、IgM水平均明显低于对照组(P<0.05)。85例脑出血合并CCS患者中,死亡14例,生存71例。死亡组血清乳酸水平显著高于生存组,IgG、IgM水平均明显低于生存组(P<0.05)。经Logistic回归模型分析得,血糖、血清乳酸水平上升及IgG、IgM降低是影响脑出血合并CCS患者死亡的危险因素(P<0.05)。ROC曲线分析结果显示:血清乳酸、IgG及IgM水平对脑出血合并CCS患者死亡具有高预测价值,联合检测的曲线下面积最大。结论:脑出血并发CCS患者中血清乳酸呈高表达,IgG、IgM呈低表达,推测与脑出血并发CCS发生、发展有关,可作为评估其预后的参考指标。

Objective:To analyze the changes and significance of lactic acid and immunoglobulin(Ig)in cerebral hemorrhage complicated by cerebro-cardiac syndrome(CCS).Methods:The clinical data of 85 patients with cerebral hemorrhage and CCS admitted to our hospital from January 2018 to July 2020 were retrospectively analyzed(study group)and 50 healthy volunteers(control group)were selected during the same period.The serum lactic acid,immunoglobulin G(IgG)and immunoglobulin M(IgM)levels were compared between the two groups.The prognosis of follow-up was counted,the serum lactate,IgG and IgM levels and the independent risk factors affecting death of patients with cerebral hemorrhage combined with CCS were compared,ROC curve was drawn,and the predictive value of different indicators for death of patients with cerebral hemorrhage with CCS was analyzed.Results:The serum lactic acid level of the study group was significantly higher than that of the control group,and the levels of IgG and IgM were significantly lower than those of the control group(P<0.05).Among 85 patients with cerebral hemorrhage and CCS,14 patients died and 71 patients survived.The serum lactate level of the death group was significantly higher than that of the survival group,and the levels of IgG and IgM were significantly lower than those of the survival group(P<0.05).The Logistic regression analysis showed that the increase of blood glucose and serum lactic acid levels and the decrease of IgG and IgM were risk factors affecting the death of patients with cerebral hemorrhage combined with CCS(P<0.05).The results of ROC curve analysis showed that serum lactic acid,IgG and IgM levels have high predictive value for the death of patients with cerebral hemorrhage combined with CCS,and the area under the combined detection curve was the largest.Conclusion:Serum lactic acid is highly expressed in patients with cerebral hemorrhage complicated by CCS,while IgG and IgM are lowly expressed,which is speculated to be related to the occurrence and development of cerebral hemorrhage complicated by CCS,and can be used as a reference index in evaluating the prognosis.