脑脊液中TXB2、S100B水平与高血压脑出血患者预后的相关性

Correlation of TXB2 and S100B in cerebrospinal fluid with prognosis of patients with hypertensive intracerebral hemorrhage

目的探究脑脊液中血栓素B2(thromboxane B2,TXB2)、S100钙结合蛋白B(S100 calcium-binding protein B,S100B)水平与高血压脑出血患者预后的相关性。方法选取2020年5月至2023年5月西安市长安医院急诊收治的高血压脑出血患者96例,均行微创血肿清除术治疗,收集所有患者的病历资料,检测患者术后24 h脑脊液中的TXB2、S100B水平。依据患者术后28 d预后分为预后良好组和预后不良组。分析高血压脑出血预后的影响因素,评价脑脊液中TXB2、S100B水平对高血压脑出血患者预后的预测效能。采用χ^(2)检验、独立样本t检验,影响因素的分析采用多因素logistic逐步回归模型。结果术后28 d,96例高血压脑出血患者中预后良好68例(70.83%),预后不良28例(29.17%)。两组性别、年龄、体重指数等一般资料比较,差异均无统计学意义(均P>0.05);预后良好组美国国立卫生研究院卒中量表(NIHSS)评分、中线移位占比及脑脊液TXB2、S100B水平均低于预后不良组[(15.34±2.61)分比(20.18±3.32)分、19.12%(13/68)比39.29%(11/28)、(156.04±17.31)ng/L比(190.35±18.29)ng/L、(1.72±0.34)μg/L比(1.93±0.47)μg/L],差异均有统计学意义(均P<0.05)。NIHSS评分(OR=3.691,95%CI 1.262~10.799)、中线移位(OR=3.425,95%CI 1.171~10.019)、脑脊液TXB2(OR=5.675,95%CI 1.939~16.602)及S100B(OR=4.486,95%CI 1.533~13.125)是高血压脑出血预后的危险因素(均P<0.05)。脑脊液中TXB2、S100B单一及联合预测高血压脑出血患者预后的灵敏度分别为0.764、0.727、0.799,特异度分别为0.641、0.703、0.782,曲线下面积分别为0.731、0.705、0.823。结论脑脊液中TXB2、S100B水平的变化与高血压脑出血患者预后有关,且两者联合检测对高血压脑出血患者预后的预测效能良好。

Objective To explore the correlation of thromboxane B2(TXB2)and S100 calcium binding protein B(S100B)in cerebrospinal fluid with the prognosis of patients with hypertensive intracerebral hemorrhage.Methods Ninety-six patients with hypertensive intracerebral hemorrhage admitted to Emergency Department,Chang'an Hospital between May 2020 and May 2023 were selected.All the patients underwent minimally invasive hematoma removal surgery.Their medical records were collected.Their levels of TXB2 and S100B in the cerebrospinal fluid were measured 24 hours after surgery.According to their prognosis 28 d after the surgery,they were divided into a good prognosis group and a poor prognosis group.The factors influencing their prognosis were analyzed.The efficacies of TXB2 and S100B in cerebrospinal fluid in the prediction of the patients'prognosis were evaluated.χ^(2) and independent-sample t tests were used.The multivariate logistic stepwise regression model was used to analyze the influencing factors.Results Twenty-eight days after the surgery,among the 96 patients,68(70.83%)had good prognosis,while the remaining 28(29.17%)had poor prognosis.There were no statistical differences in gender,age,and body mass index between the two groups(all P>0.05).The score of National Institute of Health Stroke Scale(NIHSS)and proportion of the patients with midline shift in the good prognosis group were lower than those in the poor prognosis group[(15.34±2.61)vs.(20.18±3.32),19.12%(13/68)vs.39.29%(11/28);both P<0.05].The levels of TXB2 and S100B in cerebrospinal fluid in the good prognosis group were lower than those in the poor prognosis group[(156.04±17.31)ng/L vs.(190.35±18.29)ng/L,(1.72±0.34)μg/L vs.(1.93±0.47)μg/L;both P<0.05].The score of NIHSS(OR=3.691,95%CI 1.262-10.799),proportion of the patients midline shift(OR=3.425,95%CI 1.171-10.019),and TXB2(OR=5.675,95%CI 1.939-16.602)and S100B(OR=4.486,95%CI 1.533-13.125)in cerebrospinal fluid were the risk factors for the patients'prognosis(all P<0.05).The sensitivities of TXB2 and S100B in cerebrospinal fluid and their combination in the prediction of the patients,prognosis were 0.764,0.727,and 0.799,respectively;the specificities were 0.641,0.703,and 0.782,respectively;the areas under the curves were 0.731,0.705,and 0.823,respectively.Conclusion The changes in TXB2 and S100B in cerebrospinal fluid are related to the prognosis of patients with hypertensive intracerebral hemorrhage,and both indicators have good predictive efficacies for the patients'prognosis.