血清肿瘤坏死因子相关蛋白3与D-二聚体水平对老年高血压性脑出血患者预后的影响

The effect of serum levels of CTRP-3 and D-dimer levels in elderly patients with hypertensive cerebral hemorrhage

目的 通过观察高血压性脑出血(HICH)患者血清补体C1q/肿瘤坏死因子相关蛋白3(CTRP-3)、D-二聚体(D-dimer)表达及格拉斯哥昏迷指数(GCS)情况,并分析血清CTRP-3、D-dimer表达与GCS评分之间的关系。方法 选取联勤保障部队第九二二医院神经外科180例HICH患者,对比患者血清CTRP-3、D-dimer表达,并对所有患者进行为期1个月的有效随访,依据GCS评分分为预后良好组与预后不良组,分析血清CTRP-3、D-dimer表达与HICH患者GCS评分之间的关系。结果 入组180例HICH患者均完成有效随访,其中预后良好110例,GCS(14.05±0.85)分,预后不良70例,GCS(6.12±1.05)分。相较于预后良好组,预后不良组患者血清CTRP-3、GCS评分呈低表达,D-dimer呈高表达(P<0.05),组间其他基线资料对比,差异无统计学意义(P>0.05);经双变量Spearson相关性检验结果显示,血清CTRP-3表达与HICH患者GCS评分呈正相关(r=0.694,P<0.05),血清D-dimer表达与HICH患者GCS评分呈负相关(r=-0.597,P<0.05);建立多元回归模型行多元回归分析,结果显示,血清CTRP-3低表达、血清D-dimer高表达是导致HICH患者预后不良的危险因素(OR>1,P<0.05);经绘制ROC曲线结果显示,HICH患者血清CTRP-3、D-dimer表达预测HICH患者预后的AUC分别为0.957、0.854,均>0.80,预测价值均较理想。结论 血清HICH患者血清CTRP-3、D-dimer表达与预后有关,临床可对血清CTRP-3低表达、血清D-dimer高表达的HICH患者采取针对性干预措施,旨在促进患者良性预后。

Objective To observe serum serum complement C1q/tumor necrosis factor-related protein 3(CTRP-3),D-dimer expression and Glasgow Coma Scale(GCS)score in patients with hypertensive cerebral hemorrhage(HICH),and to analyze the relationship between serum serum CTRP-3,D-dimer expression and GCS score.Methods Selecting 180 HICH patients from department of neurosurgery of the 922nd Hospital of Joint Logistics Support Forces,serum CTRP-3 and D-dimer expressions were compared,and all patients were effectively followed up for 1 month,and divided into good prognosis and poor prognosis groups according to GCS scores.Results Among them,110 patients had a good prognosis with a mean GCS score of(14.05±0.85)and 70 patients had a poor prognosis with a mean GCS score of(6.12±1.05).Compared with the good prognosis group,the patients in the poor prognosis group showed low expression of serum CTRP-3 and GCS score and high expression of D-dimer(P<0.05),and the differences were not statistically significant when comparing other baseline data between groups(P>0.05);the results of bivariate Spearson correlation test showed that serum CTRP-3 expression was positively correlated with GCS score of HICH patients(r=0.694,P<0.05)and serum D-dimer expression was negatively correlated with GCS scores of HICH patients(r=-0.597,P<0.05);multiple regression analysis showed that low serum CTRP-3 expression and high serum D-dimer expression were risk factors for poor prognosis of HICH patients(OR>1,P<0.05);the ROC curve showed that the AUCs of serum CTRP-3 and D-dimer expression in HICH patients to predict the prognosis of HICH patients were 0.957 and 0.854,respectively,both of which were>0.80,and both of which had a good predictive value.Conclusions Serum CTRP-3 and D-dimer expression in patients with serum HICH is related to prognosis,and clinical interventions can be targeted to HICH patients with low serum CTRP-3 expression and high serum D-dimer expression,aiming to promote a favorable prognosis.