急性出血性脑卒中患者血清S100B、PDGF-D、h-FABP 及NSE水平与颅内血肿扩大的关系

Relationship between the serum levels of S100B,PDGF-D,H-FABP and NSE and intracranial hematoma enlargement in patients with acute hemorrhagic stroke

目的探讨急性出血性脑卒中患者血清S100钙结合蛋白B(S100B)、血小板衍生生长因子-D(PDGF-D)、心脏型脂肪酸结合蛋白(h-FABP)及神经元特异性烯醇化酶(NSE)水平与颅内血肿扩大的关系。方法前瞻性从2019年9月至2020年9月该院接诊的急性出血性脑卒中患者中随机选取125例作为研究对象,根据是否出现颅内血肿扩大,将患者分为血肿未扩大组(82例)和血肿扩大组(43例)。检测并比较两组发病后第1天、第7天、第90天的血清S100B、PDGF-D、h-FABP、NSE水平,记录并比较两组入院时的血肿量(V1)和第1次复查CT时的血肿量(V2)以及V2/V1比值,采用Logistic回归模型分析颅内血肿扩大的影响因素。结果发病后两组内各时间点血清S100B、PDGF-D、h-FABP、NSE水平随时间推移均明显下降(P<0.05);发病后第1天、第7天血肿扩大组S100B、PDGF-D、h-FABP、NSE水平均高于血肿未扩大组(P<0.05),发病后第90天两组S100B、PDGF-D、h-FABP、NSE水平差异无统计学意义(P>0.05)。两组V1差异无统计学意义(P>0.05),但血肿扩大组V2及V2/V1比值均大于血肿未扩大组(P<0.05)。Logistic回归模型分析结果显示,更高水平S100B、PDGF-D、h-FABP和NSE是急性出血性脑卒中患者血肿扩大的独立影响因素(OR=1.853、1.624、1.842、1.673,P<0.05)。结论发生颅内血肿扩大的急性出血性脑卒中患者血清S100B、PDGF-D、h-FABP和NSE水平升高更为明显,它们均为急性出血性脑卒中患者血肿扩大的独立影响因素。

Objective To investigate the relationship between the serum levels of S100 calcium binding protein B(S100B),platelet-derived growth factor D(PDGF-D),heart fat acid binding protein(H-FABP)and neuron-specific enolase(NSE)and intracranial hematoma enlargement in patients with acute hemorrhagic stroke.Methods Prospectively,a total of 125 patients with acute hemorrhagic stroke who were admitted to this hospital from September 2019 to September 2020 were randomly selected.According to whether the intracranial hematoma was enlarged,the patients were divided into the non-hematoma enlargement group(82 cases)and the hematoma enlargement group(43 cases).The serum levels of S100B,PDGF-D,h-FABP and NSE were detected and compared between the two groups on the 1st,7th and 90th day after the onset of the disease.The hematoma volume(V1)on admission,the hematoma volume(V2)at the first re-examination CT and the ratio of V2/V1 were recorded and compared between the two groups.Logistic regression model was used to analyze the influencing factors of intracranial hematoma enlargement.Results The serum levels of S100B,PDGF-D,h-FABP and NSE at each time point in the two groups significantly decreased over time after the onset of the disease(P<0.05);the levels of S100B,PDGF-D,h-FABP and NSE in the hematoma enlargement group were higher than those in the non-hematoma enlargement group on the 1st and 7th day after the onset of the disease(P<0.05),and there were no statistically significant differences in the levels of S100B,PDGF-D,h-FABP and NSE between the two groups on the 90th day after the onset(P>0.05).There was statistically significant differences in the V1 between the two groups(P>0.05),but the V2 and the ratio of V2/V1 in the hematoma enlargement group were higher than those in tthe non-hematoma enlargement group(P<0.05).Logistic regression model analysis results showed that higher levels of S100B,PDGF-D,h-FABP and NSE were independent influencing factors of hematoma enlargement in patients with acute hemorrhagic stroke(OR=1.853,1.624,1.842,1.673,P<0.05).Conclusion The serum levels of S100B,PDGF-D,h-FABP and NSE significantly increase in acute hemorrhagic stroke patients with intracranial hematoma enlargement.They are all independent influencing factors for hematoma enlargement in acute hemorrhagic stroke patients.