血清巨噬细胞移动抑制因子、Tau蛋白在重症高血压性脑出血患者中的表达水平及与其临床结局的关系研究

Expression of serum macrophage migration inhibitory factor and Tau protein in patients with severe hypertensive intracerebral hemorrhage and their relationships with clinical outcome

目的 探究血清巨噬细胞移动抑制因子(MIF)、Tau蛋白在重症高血压性脑出血(HICH)患者中的表达水平,并分析两者水平与重症HICH患者临床结局的关系,为该类患者临床治疗提供参考。方法 选取四川大学华西医院资阳医院在2019年1月-2022年11月收治的120例重症HICH患者作为研究组,同时选取与研究组年龄、性别相匹配的健康体检者50例作为对照组,比较两组患者的MIF、Tau蛋白水平。对研究组患者进行半年以上随访,根据标准重新分为预后不良组和预后良好组,比较两组患者MIF、Tau蛋白水平,并采用ROC曲线和Kaplan-Meier法探究患者预后不良的MIF、Tau蛋白水平临界值及与重症HICH患者临床结局的关系。结果 研究组患者的血清MIF水平和Tau蛋白水平均显著高于对照组受试者(P<0.05);预后不良组患者血清MIF水平和Tau蛋白水平显著高于预后良好组(P<0.05);ROC曲线显示,血清MIF水平和Tau蛋白水平预测患者预后不良的最佳截断点分别为64.43 ng/L,216.25 pg/ml,血清MIF水平预测HICH患者预后不良的曲线下面积、敏感度和特异度分别为0.815(95%CI=0.759~0.849)、81.56%、83.24%,且血清Tau蛋白水平分别为0.847(95%CI=0.764~0.831)、82.26%、79.68%,均处于较高水平;血清MIF水平≥64.43 ng/L时的患者生存曲线明显优于血清MIF水平<64.43 ng/L的生存曲线,血清Tau蛋白水平<216.25 pg/ml时的患者生存曲线也明显优于血清Tau蛋白水平≥216.25 pg/ml时的生存曲线。Log/rank检验显示两者差异均具有统计学意义(P<0.05)。结论 重症HICH患者的血清MIF、Tau蛋白水平较健康人显著升高,且预后不良患者的血清MIF、Tau蛋白水平较预后良好患者更高,血清MIF、Tau蛋白水平与患者临床结局密切相关,可作为预测HICH患者预后情况的有效指标。

Objective To explore the expression levels of serum macrophage migration inhibitory factor(MIF)and Tau protein in patients with severe hypertensive intracerebral hemorrhage(HICH),and analyze the relationships between their levels and patient outcome,and to provide a reference for clinical treatment of such patients.Methods We included 120 patients with severe HICH and 50 age-and sex-matched healthy controls from health examination in Ziyang Hospital of West China Hospital of Sichuan University from January 2019 to November 2022.The MIF and Tau protein levels of the two groups were compared.After a follow-up of more than half a year,the patients were divided into poor-prognosis group and good-prognosis group according to the defined criteria to compare their levels of MIF and Tau protein.The receiver operating characteristic(ROC)curve and Kaplan-Meier method were used to explore the critical values of MIF and Tau protein levels for patients with poor prognosis and the relationships with the clinical outcome of severe HICH.Results The levels of serum MIF and Tau protein in the patients with severe HICH were significantly higher than those in the control group(P<0.05).The poor-prognosis group showed significantly higher levels of serum MIF and Tau protein than the good-prognosis group(P<0.05).The ROC curve showed that the cutoff points of serum MIF and Tau protein levels for predicting poor prognosis were 64.43 ng/L and 216.25 pg/ml,respectively.The area under the curve for using MIF to predict poor prognosis was 0.815(95%CI=0.759-0.849),with sensitivity of 81.56%and specificity of 83.24%,and those values for using Tau protein to predict poor prognosis were 0.847(95%CI=0.764-0.831),82.26%,and 79.68%,respectively,all at high levels.Patients with serum MIF level<64.43 ng/L had significantly better survival than those with serum MIF level≥64.43 ng/L(P<0.05 by log-rank test).Patients with serum Tau protein level<216.25 pg/ml had significantly better survival than those with serum Tau protein level≥216.25 pg/ml(P<0.05 by log-rank test).Conclusion Patients with severe HICH had significantly higher serum MIF and Tau protein levels than healthy people.The patients with poor prognosis had significantly higher serum MIF and Tau protein levels than those with good prognosis.Serum MIF and Tau protein levels were closely related to the clinical outcome of the patients,which can be used as effective indicators to predict the prognosis of patients with HICH.