血清神经丝轻链蛋白与脑出血患者预后的相关性研究

Study on the correlation between serum neurofilament light chain protein and prognosis of patients with intracerebral hemorrhage

目的探讨脑出血患者血清神经丝轻链蛋白(NFL)与脑出血神经功能缺损程度及预后的相关性。方法选取2020年6月至2021年8月蚌埠医学院第二附属医院脑出血首发30例患者为观察组,选取同期74例健康体检者为对照组。所有患者按照美国国立卫生研究院脑卒中量表(NIHSS)评估神经功能缺损状况,并用改良Rankin(mRS)量表评估患者发病30 d后的预后结局,mRS≤2分作为预后良好组,mRS>2分作为预后不良组。采用Meso Scale Discovery(MSD)电化学发光法,检测对照组和观察组入院后第0、3、7天的血清NFL水平。采用t检验和单因素方差分析血清NFL与患者预后的相关性。结果观察组0、3、7 d血清NFL水平高于对照组,差异有统计学意义(P<0.01)。血清NFL水平随发病时间逐渐升高,第3、7天的血清NFL水平均高于第0天,差异有统计学意义(P<0.05);第7天的血清NFL水平高于第3天,差异有统计学意义(P<0.05)。脑出血第3、7天预后不良组患者血清NFL升高数值均高于预后良好组,差异均有统计学意义(P<0.05)。结论脑出血患者血清NFL检测在脑出血损伤中起着重要作用,可作为评估神经功能缺损程度及预后的观察指标之一。

Objective To investigate the correlation between serum neurofilament light chain(NFL)and neurological impairment and prognosis in patients with cerebral hemorrhage.Methods A total of 30 patients with intracerebral hemorrhage admitted to the Second Affiliated Hospital of Bengbu Medical College from June 2020 to August 2021 were selected as the observation group,and 74 healthy people in the same period were selected as the control group.Neurological deficits were assessed using the National Institute of Health stroke scale(NIHSS).The primary outcome was day-30 modified Rankin score(mRS).Then mRS≤2 was regarded as the group with poor functional status,mRS>2 was regarded as the group with good functional status.Meso Scale Discovery(MSD)electrochemiluminescence method was used to quantify the serum NFL levels of the control group and the observation group on the 0,3rd and 7th days after admission.Results The level of serum NFL in the observation group was higher than that in the control group on 0,3rd and 7th days,and the difference was statistically significant(P<0.01).The serum NFL level increased and peaked at 7th day.The serum NFL level on the 3rd day and 7th day were higher than that on the 0 day,and the differences were statistically significant(P<0.05).The serum NFL level on the 7th day was higher than that on the 3rd day,and the difference was statistically significant(P<0.05).The increment of serum NFL in patients with poor prognosis on the 3rd day and 7th day were higher than that in patients with good prognosis,and the differences were statistically significant(P<0.05).Conclusion The serum NFL level plays an important role in intracerebral hemorrhage,and it holds promise as an indicator of neurological deficits and prognosis.