高血压脑出血患者血清热休克蛋白47和血管生成素样蛋白4水平及其预后价值

Serum HSP47 and ANGPTL4 levels and their prognostic values for patients with hypertensive intracerebral hemorrhage

目的探究高血压脑出血(HICH)患者血清热休克蛋白47(HSP47)、血管生成素样蛋白4(ANGPTL4)水平与病情严重程度的相关性及其对预后的评估价值。方法选择2020年2月至2022年2月聊城市人民医院神经内科收治的HICH患者154例为HICH组,其中预后不良46例和预后良好108例。以同期体检健康者64例为对照组。检测各组血清HSP47、ANGPTL4水平。结果HICH组血清HSP47、ANGPTL4水平明显高于对照组[(467.04±83.22)ng/L vs(286.35±62.71)ng/L,(23.75±4.86)μg/L vs(9.60±2.69)μg/L,P<0.01]。预后不良患者血清HSP47、ANGPTL4水平明显高于预后良好患者(P<0.01)。出血量、破入脑室、神经功能缺损程度、HSP47、ANGPTL4是影响预后不良的危险因素(P<0.05,P<0.01)。HSP47和ANGPTL4联合预测预后不良的曲线下面积(AUC)明显高于HSP47、ANGPTL4的AUC(P<0.05)。结论HICH患者血清ANGPTL4、HSP47水平均升高,高水平ANGPTL4、HSP47与神经损伤程度及预后不良有关,二者联合检测可为预测预后提供参考。

Objective To detect the serum levels of HSP47 and ANGPTL4 in patients with hypertensive intracerebral hemorrhage(HICH),and investigate their correlation with the severity and prognosis of the disease.Methods A total of 154 HICH patients admitted to the Department of Neurology of Liaocheng People􀆳s Hospital from February 2020 to February 2022 were selected as the HICH group.According to the Glasgow prognosis score,46 patients had poor prognosis and 108 patients had good prognosis.Another 64 healthy individuals during the same period were taken as control group.Their serum HSP47 and ANGPTL4 levels were detected.Results The serum levels of HSP47 and ANGPTL4 were significantly higher in the HICH group than the control group(467.04±83.22 ng/L vs 286.35±62.71 ng/L,23.75±4.86μg/L vs 9.60±2.69μg/L,P<0.01).The levels in the patients with poor prognosis were significantly higher than those in the good prognosis group(P<0.01).Hemorrhage volume,ventricle rupture,severity of neurological deficit,and HSP47 and ANGPTL4 levels were the influencing factors of poor prognosis(P<0.05,P<0.01).The AUC of HSP47 and ANGPTL4 combination for predicting poor prognosis was significantly higher than that of single indicator(P<0.05).Conclusion The serum levels of ANGPTL4 and HSP47 are increased in HICH patients.Their high levels are related to the severity of nerve damage and poor prognosis.The combination of the 2 indicators can provide a reference for predicting prognosis.