sLOX-1 HIF-1α IGF-1对动脉瘤性蛛网膜下腔出血后迟发性脑缺血的预测价值研究

Predictive Value of sLOX-1, HIF-1α and IGF-1 on Delayed Cerebral Ischemiaafter Aneurysmal Subarachnoid Hemorrhage

目的:探讨可溶性凝集素样氧化型低密度脂蛋白受体-1(sLOX-1)、缺氧诱导因子-1α(HIF-1α)、胰岛素样生长因子-1(IGF-1)对动脉瘤性蛛网膜下腔出血(aSAH)后迟发性脑缺血(DCI)的预测价值研究。方法:选取我院2019年3月至2022年3月期间104例aSAH患者作为研究对象,根据DCI发生情况分为DCI组和非DCI组,比较两组一般临床资料[三酰甘油(TG)、颅内压(ICP)、Hunt-Hess分级]及血清sLOX-1、HIF-1α、IGF-1水平,采用Pearson相关性分析血清sLOX-1、HIF-1α、IGF-1与TG、ICP、Hunt-Hess分级的相关性,绘制受试者工作特征(ROC)曲线,评估血清sLOX-1、HIF-1α、IGF-1对aSAH后DCI的预测效能。结果:DCI组TG、ICP、Hunt-Hess分级均高于非DCI组(P<0.05);DCI组血清sLOX-1、HIF-1α水平均高于非DCI组(P<0.05),IGF-1水平低于非DIC组(P<0.05);Pearson相关性分析显示,血清sLOX-1、HIF-1α水平与TG、ICP、Hunt-Hess分级均呈正相关(P<0.05),血清IGF-1水平与TG、ICP、Hunt-Hess分级均呈负相关(P<0.05);ROC曲线显示,血清sLOX-1、HIF-1α、IGF-1单独及联合预测aSAH后DCI的敏感度/特异度分别为87.10%/79.50%、90.30%/83.60%、83.90%/79.50%、96.80%/78.10%,对应的AUC分别为0.894、0.920、0.886、0.975。结论:sLOX-1、HIF-1α、IGF-1与aSAH后DCI的发生有关,联合检测可在一定程度上预测aSAH后DCI。

Objective:To explore the predictive value of soluble lectin-like oxidized low-density lipoprotein receptor-1(sLOX-1),hypoxia-inducible factor-1α(HIF-1α),and insulin-like growth factor-1(IGF-1)on delayed cerebral ischemia(DCI)after aneurysmal subarachnoid hemorrhage(aSAH).Methods:A total of 104 patients with aSAH in the hospital from March 2019 to March 2022 were selected as the research subjects.According to the occurrence of DCI,the patients were divided into a DCI group and a non-DCI group.The general clinical data[triacylglycerol(TG),intracranial pressure(ICP),Hunt-Hess grading]and serum sLOX-1,HIF-1α,and IGF-1 levels were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between serum sLOX-1,HIF-1α,IGF-1 and TG,ICP,and Hunt-Hess grading.The receiver operating characteristic(ROC)curve was drawn to assess the predictive efficiency of serum sLOX-1,HIF-1α,and IGF-1 on DCI after aSAH.Results:The TG,ICP and Hunt-Hess grading in the DCI group were higher than those in the non-DCI group(P<0.05).The levels of serum sLOX-1 and HIF-1αin the DCI group were higher than those in the non-DCI group(P<0.05)while the level of IGF-1 was lower than that in the non-DIC group(P<0.05).Pearson correlation analysis showed that serum sLOX-1 and HIF-1αlevels were positively correlated with TG,ICP,and Hunt-Hess grading(P<0.05),but serum IGF-1 level was negatively correlated with TG,ICP,and Hunt-Hess grading(P<0.05).ROC curve showed that the sensitivities and specificities of serum sLOX-1,HIF-1α,IGF-1 alone and in combination on predicting DCI after aSAH were 87.10%/79.50%,90.30%/83.60%,83.90%/79.50%,and 96.80%/78.10%respectively,and the corresponding AUCs were 0.894,0.920,0.886,and 0.975 respectively.Conclusion:sLOX-1,HIF-1α,and IGF-1 are related to the occurrence of DCI after aSAH,and combined detection can predict DCI after aSAH to a certain extent.