血清PDGF-D、GDF-15和D-D水平与出血性脑卒中患者脑血肿进展的关系

Relationship between levels of serum PDGF⁃D,GDF⁃15 and D⁃D and progression of cere⁃bral hematoma in patients with hemorrhagic stroke

目的 分析血清血小板源性生长因子-D(PDGF-D)、生长分化因子-15(GDF-15)和D-二聚体(D-D)与出血性脑卒中患者脑血肿进展的关系。方法 选取2018年12月至2023年5月西部战区总医院205例出血性脑卒中患者,根据脑血肿有无扩大情况将其分为扩大组(n=84)和未扩大组(n=121)。比较两组一般资料和血清PDGF-D、GDF-15、D-D水平,绘制受试者工作特征曲线(ROC)曲线评估血清PDGF-D、GDF-15、D-D指标对出血性脑卒中患者为脑血肿扩大的诊断价值。采用Pearson相关性分析脑血肿扩大组血清PDGF-D、GDF-15、D-D指标与格拉斯哥昏迷评分(GCS)评分的相关性。结果 扩大组GCS评分、收缩压、舒张压、血清PDGF-D、GDF-15、D-D指标高于未扩大组,差异有统计学意义(P<0.05)。PDGF-D、GDF-15、D-D和联合检测诊断出血性脑卒中患者脑血肿扩大的AUC分别为0.824、0.785、0.790、0.938。出血性脑卒中且脑血肿扩大患者血清PDGF-D、GDF-15、D-D指标与GCS评分具有负弱相关性(P<0.05)。结论出血性脑卒中脑血肿扩大患者血清PDGF-D、GDF-15、D-D水平明显高于脑血肿未扩大患者,血清PDGF-D、GDF-15、D-D水平对于诊断出血性脑卒中患者是否出现脑血肿扩大具有重要意义。

Objective To analyze the relationship of serum platelet-derived growth factor-D(PDGF-D),growth differentiation factor-15(GDF-15)and D-dimer(D-D)with progression of cerebral hematoma in patients with hemorrhagic stroke.Methods 205 patients with hemorrhagic stroke admitted to Western Theater General Hospital were selected from December 2018 to May 2023.According to the presence or absence of enlargement of cerebral hematoma,the patients were divided into the enlargement group(n=84)and the non-enlargement group(n=121).The general data and levels of serum PDGF-D,GDF-15 and D-D were compared between the two groups,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of serum PDGF-D,GDF-15 and D-D on cerebral hematoma enlargement in patients with hemorrhagic stroke.Correlation of serum PDGF-D,GDF-15 and D-D with Glasgow Coma Scale(GCS)score in cerebral hematoma enlargement group was analyzed by Pearson correlation analysis.Results The GCS score,systolic blood pressure,diastolic blood pressure and levels of serum PDGF-D,GDF-15 and D-D in the enlargement group were higher than those in the non-enlargement group(P<0.05).The AUC values of PDGF-D,GDF-15,D-D and combined detection in the diagnosis of cerebral hematoma enlargement in patients with hemorrhagic stroke were 0.824,0.785,0.790 and 0.938,respectively.The levels of serum PDGF-D,GDF-15 and D-D in patients with hemorrhagic stroke and cerebral hematoma enlargement were weakly negatively correlated with GCS score(P<0.05).Conclusion The levels of serum PDGF-D,GDF-15 and D-D in patients with hemorrhagic stroke and cerebral hematoma enlargement are significantly higher than those in patients without cerebral hematoma enlargement,and serum PDGF-D,GDF-15 and D-D are of great significance for diagnosing whether patients with hemorrhagic stroke have cerebral hematoma enlargement.