血清FGFR-1、T-AOC、HPA在危重脑室出血患者中的表达水平及其与预后的相关性分析

Changes of serum FGFR-1,T-AOC,HPA levels and their relationship with prognosis in patients with critical ventricular hemorrhage

目的分析血清成纤维细胞生长因子受体-1(FGFR-1)、总抗氧化能力(T-AOC)、乙酰肝素酶(HPA)在危重脑室出血患者中的表达水平及其与预后的相关性。方法回顾性选择自2019年6月至2022年12月东南大学附属中大医院接诊的90例危重脑室出血患者作为病例组,根据发病后30 d的格拉斯哥预后量表(GOS)分为预后良好组(GOS评分>3分,n=48)和预后不良组(GOS评分≤3分,n=42);另选同期的90名健康体检者作为对照组。检测所有入选者血清FGFR-1、T-AOC、HPA水平,分析危重脑室出血患者血清FGFR-1、T-AOC、HPA水平与急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、美国国立卫生研究院卒中量表(NIHSS)评分、血肿体积的关系,使用受试者工作特征(ROC)曲线分析血清FGFR-1、T-AOC、HPA对危重脑室出血患者短期预后不良的预测效能。结果病例组血清FGFR-1、T-AOC水平分别为(3.42±0.58)μg/mL、(3.03±1.14)U/mL,均低于对照组[(8.08±1.57)μg/mL、(5.98±1.72)U/mL],HPA水平为(5.69±1.06)ng/mL,高于对照组[(1.25±0.37)ng/mL],差异均有统计学意义(P<0.05)。预后不良组血清FGFR-1、T-AOC水平分别为(5.72±1.24)μg/mL、(2.05±0.67)U/mL,低于预后良好组[(10.36±2.51)μg/mL、(4.21±1.36)U/mL],HPA水平为(8.46±2.25)ng/mL,高于预后良好组[(3.72±1.13)ng/mL],差异均有统计学意义(P<0.05)。经Pearson相关性分析,危重脑室出血患者APACHEⅡ评分、NIHSS评分、血肿体积均与血清FGFR-1、T-AOC水平呈负相关(P<0.05),与血清HPA水平呈正相关(P<0.05)。经多因素Logistic回归分析,血清FGFR-1、T-AOC、HPA均是危重脑室出血患者短期预后不良的独立预测因素(P<0.05);经ROC曲线分析,血清FGFR-1、T-AOC联合HPA预测危重脑室出血患者短期预后不良的曲线下面积(AUC)为0.900。结论危重脑室出血患者血清FGFR-1、T-AOC水平均明显降低,HPA水平明显升高,三者均与病情严重程度有关,联合判断短期预后不良的效能较好,值得进一步研究应用。

Objective To analyze the changes of serum FGFR-1alase(FGFR-1),total antioxidant capacity(T-AOC),heparinase(HPA)and their relationship with prognosis in patients with critical ventricular hemorrhage.Methods Ninety patients with critical ventricular hemorrhage admitted to Zhongda Hospital Southeast University from June 2019 to December 2022 were selected as case group.According to Glasgow outcome scale(GOS)30 days after onset,they were divided into good prognosis group(GOS score>3 points,n=48)and poor prognosis group(GOS score≤3 points,n=42).Another 90 healthy subjects in the same period were selected as control group.Serum FGFR-1,T-AOC and HPA levels of all the candidates were detected,and the relationship between serum FGFR-1,T-AOC and HPA levels and acute physiology and chronic health status evaluation(APACHEⅡ)score,National Institute of Health stroke scale(NIHSS)score and hematoma volume in patients with critical ventricular hemorrhage was analyzed.The predictive efficacy of serum FGFR-1,T-AOC and HPA on short-term poor prognosis in patients with critical ventricular hemorrhage was analyzed using receiver operating characteristic(ROC)curve.Results The levels of serum FGFR-1 and T-AOC in the case group were(3.42±0.58)μg/mL,(3.03±1.14)U/mL,respectively,which were lower than those in the control group[(8.08±1.57)μg/mL,(5.98±1.72)U/mL],the level of HPA in the case group was(5.69±1.06)ng/mL,which was higher than that in the control group[(1.25±0.37)ng/mL],the differences were statistically significant(P<0.05).The levels of serum FGFR-1 and T-AOC in the poor prognosis group were(5.72±1.24)μg/mL,(2.05±0.67)U/mL,respectively,which were lower than those in the good prognosis group[(10.36±2.51)μg/mL,(4.21±1.36)U/mL],the level of HPA in the poor prognosis group was(8.46±2.25)ng/mL,which was higher than that in the good prognosis group[(3.72±1.13)ng/mL],the differences were statistically significant(P<0.05).According to Pearson correlation analysis,the APACHEⅡscore,NIHSS score,and hematoma volume in critically ill patients with ventricular hemorrhage were negatively correlated with serum FGFR-1 and T-AOC levels(P<0.05),and positively correlated with serum HPA levels(P<0.05).Multiple Logistic regression analysis showed that serum FGFR-1,T-AOC and HPA were independent predictors of poor short-term prognosis in patients with critical ventricular hemorrhage(P<0.05).According to ROC curve analysis,the area under the curve(AUC)of serum FGFR-1 and T-AOC combined with HPA in predicting the short term poor prognosis of patients with critical ventricular hemorrhage was 0.900.Conclusion Serum FGFR-1 and T-AOC levels were significantly decreased in patients with critical ventricular hemorrhage,while HPA levels were increased,the three levels were related to the severity of the disease,and the combined determination of poor short-term prognosis was effective,worthy of further study and appliFGFR-1ion.