血清高迁移率族蛋白Bl、白细胞介素-6与高血压性脑出血患者神经内镜微创术后神经功能及预后的关系

Relationship Between Serum High Mobility Group Box 1 and Interleukin-6 Levels and Postoperative Neurological Function and Prognosis in Hypertensive Intracerebral Hemorrhage Patients Undergoing Neuroendoscopic Surgery

目的探讨血清高迁移率族蛋白Bl(HMGB1)、白细胞介素-6(IL-6)水平与高血压性脑出血(HICH)患者神经内镜微创术后神经功能及预后的关系。方法选取2018年6月至2022年12月许昌市中心医院收治的336例HICH患者作为研究对象,根据神经内镜微创术后神经功能缺损程度分为轻型组、中型组及重型组,并根据术后预后状态分为预后良好组和预后不良组。分析HICH患者血清HMGB1、IL-6水平与美国国立卫生研究院卒中量表(NIHSS)评分的相关性及对预后的预测效能,探讨影响HICH患者预后的因素。结果HICH患者术后血清HMGB1、IL-6水平及NIHSS评分均低于术前,且二者与NIHSS评分均呈正相关;血清HMGB1和IL-6水平均随神经功能缺损程度的增加而升高,预后不良组患者术后血清HMGB1和IL-6水平均高于预后良好组;术中出血量、出血部位、出血破入脑室、术前格拉斯哥昏迷(GCS)评分、血肿清除率、NIHSS评分、HMGB1和IL-6均为HICH患者预后不良的危险因素;术后血清HMGB1和IL-6二者联合检测对患者预后的预测效能优于各自单独检测(Z_(二者联合-HMGB1)=2.236、Z_(二者联合-IL-6)=1.974,P=0.034、0.017)。结论HICH患者行神经内镜微创术后血清HMGB1、IL-6水平与其神经功能康复密切相关,二者联合检测对患者的预后状态具有预测效能。

Objective To explore the relationship between serum high mobility group box 1(HMGB1),interleukin-6(IL-6)levels and postoperative neurological function and prognosis in hypertensive intracerebral hemorrhage(HICH)patients undergoing neuroendoscopic surgery.Methods A total of 336 HICH patients admitted to Xuchang Central Hospital from June 2018 to December 2022 were selected as the research subjects.They were divided into mild group,medium group,and severe group based on their degree of neurological functional impairment after neuroendoscopic surgery.They were also divided into good prognosis group and poor prognosis group based on their postoperative prognosis.The correlation between serum HMGB1 and IL-6 levels and the National Institutes of Health Stroke Scale(NIHSS)score,as well as the predictive efficacy of serum HMGB1 and IL-6 levels for the prognosis of HICH patients after neuroendoscopic surgery were analyzed.The factors affecting the prognosis of HICH patients were explored.Results The postoperative levels of serum HMGB1 and IL-6 and NIHSS score in HICH patients were lower than those before surgery(P<0.05).And the postoperative levels of serum HMGB1 and IL-6 were positively correlated with the NIHSS score.The postoperative levels of serum HMGB1 and IL-6 increased with the degree of neurological impairment(P<0.05),and those in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Intraoperative bleeding volume,bleeding site,cerebral hemorrhage breaking into the ventricle,preoperative Glasgow Coma Score(GCS),hematoma clearance rate,NIHSS score,HMGB1,and IL-6 were all risk factors for poor prognosis in HICH patients.The combined detection of postoperative serum HMGB1 and IL-6 was superior to their single detection in predicting the prognosis of patients(Z_(combined detection-HMGB1)=2.236,Z_(combined detection-IL-6)=1.974,P=0.034,0.017).Conclusion The serum levels of HMGB1 and IL-6 in HICH patients after neuroendoscopic surgery are closely related to their neurological function recovery.And the combined detection of the two can predict the prognosis of patients.