脑出血患者脑脊液中蛋白激酶R样内质网激酶水平检测及临床意义

Detection and clinical significance of protein kinase R-like endoplasmic reticulum kinase in cerebrospinal fluid of patients with cerebral hemorrhage

目的探讨脑出血患者脑脊液中蛋白激酶R样内质网激酶(PERK)水平检测的意义。方法选取2019年3月—2021年5月青岛市中医医院收治的121例脑出血患者为研究对象。自患者入院治疗后随访6个月,收集患者基本资料。检测不同病情严重程度脑出血患者的PERK水平,采用多因素Logistic回归模型分析影响脑出血患者预后的因素;绘制ROC曲线分析脑脊液中PERK水平预测脑出血患者预后的价值。结果重度病情组的PERK水平高于轻度与中度病情组(P<0.05),中度病情组的PERK水平高于轻度病情组(P<0.05)。121例患者随访期间预后不良30例,剩余91例预后良好。多因素Logistic回归模型分析显示美国国立卫生研究院卒中量表(NIHSS)评分[O^R=7.294(95%CI:3.00,17.73)]、格拉斯哥昏迷评分(GCS)[O^R=5.217(95%CI:2.15,12.68)]、颅内压[O^R=4.943(95%CI:2.03,12.01)]、PERK[O^R=4.536(95%CI:1.87,11.02)]是影响脑出血患者预后的危险因素(P<0.05)。ROC曲线分析结果显示,脑脊液中PERK水平预测脑出血患者预后的敏感性为76.67%(95%CI:0.573,0.894),特异性为80.22%(95%CI:0.703,0.876),AUC为0.772(95%CI:0.660,0.884)。结论脑出血患者脑脊液中PERK水平不仅与患者病情有关,也与患者预后有关,PERK预测脑出血患者预后效能良好。

Objective To investigate the significance of r-like endoplasmic reticulum kinase(PERK)in cerebrospinal fluid(CSF)of patients with cerebral hemorrhage.Methods From March 2019 to May 2021,121 patients with intracerebral hemorrhage admitted to our hospital were selected as the study subjects,and they were followed up for 6 months after admission.Basic data of patients were collected.PERK levels of patients with intracerebral hemorrhage of different severity were analyzed.Factors influencing the prognosis of patients with intracerebral hemorrhage were analyzed.The prognostic value of PERK levels in cerebrospinal fluid was analyzed.Results The PERK level of the severe patients was higher than the mild and moderate patients(P<0.05),and the PERK level of the moderate patients was higher than the mild patients(P<0.05).30 had poor prognosis during follow-up,and 91 had good prognosis of the 121 patients.Logistic multivariate regression analysis showed that national Institutes of Health Stroke Scale(NIHSS)score[O^R=7.294(95%CI:3.00,17.73)],Glasgow Coma Score(GCS)[O^R=5.217(95%CI:2.15,12.68)],intracranial pressure[O^R=4.943(95%CI:2.03,12.01)],and PERK[O^R=4.536(95%CI:1.87,11.02)]levels were prognostic risk factors in patients with CEREBRAL hemorrhage(P<0.05).ROC curve analysis showed that PERK in CSF had a sensitivity of 76.67%(95%CI:0.573,0.894),a specificity of 80.22%(95%CI:0.703,0.876),and an AUC of 0.772(95%CI:0.660,0.884).Conclusion The level of PERK in cerebrospinal fluid of patients with intra cerebral hemorrhage is not only related to the patient's condition,but also the patient's prognosis.PERK is a good predictor of the prognosis of patients with intracerebral hemorrhage.