血清netrin-1对急性脑出血早期神经功能恶化的预测价值

Predictive Value of Serum Netrin-1 in the Early Deterioration of Neurological Function in Acute Cerebral Hemorrhage

目的探讨血清神经轴突导向因子-1(netrin-1)对急性脑出血(ACH)早期神经功能恶化的预测价值。方法选取2019年10月至2020年10月平顶山第二人民医院收治的80例ACH患者为研究对象,根据有无神经功能恶化分为恶化组(27例)与非恶化组(53例)。采用酶联免疫吸附法检测患者血清netrin-1。采用受试者工作特征(ROC)曲线评价血清netrin-1预测ACH早期神经功能恶化的价值,采用多因素logistic回归分析ACH早期神经功能恶化的相关因素。结果恶化组出血容量、破入脑室、美国国立卫生研究院卒中量表(NIHSS)评分、血清netrin-1水平高于非恶化组(P<0.05)。ROC曲线分析显示,血清netrin-1预测ACH早期神经功能恶化的曲线下面积(95%CI)为0.843(0.732~0.941),截断值412.37 ng·L^(-1),特异度为74.28%,敏感度为84.69%。多因素logistic回归分析显示,高水平netrin-1(OR=2.82,95%CI:1.43~5.57)是ACH患者早期神经功能恶化的影响因素之一(P<0.05)。结论血清netrin-1在ACH早期神经功能恶化患者中升高,能够作为预测脑出血早期神经功能恶化的潜在参考指标之一,为早期诊治提供参考依据。

Objective To investigate the predictive value of serum nerve axon guidance factor-1(netrin-1)in the early deterioration of neurological function in acute cerebral hemorrhage(ACH).Methods A total of 80 patients with ACH who were admitted and diagnosed in Pingdingshan the Second People’s Hospital from October 2019 to October 2020 were selected as the research objects.According to the progress of neurological deterioration,they were divided into deterioration group(27 cases)and non-deterioration group(53 cases).Enzyme-linked immunosorbent assay was used to detect the level of netrin-1 of the two groups.The receiver operating characteristic(ROC)curve was used to evaluate the value of serum netrin-1 in predicting the early neurological deterioration of ACH.At the same time,multivariate logistic regression was used to analyze the related factors of the early neurological deterioration of ACH.Results The bleeding volume,rupture of the ventricle,National Institute of Health stroke scale(NIHSS)score and serum netrin-1 levels in the deterioration group were higher than those in the non-deterioration group(P<0.05).ROC curve analysis showed that the area under the curve(95%CI)of serum netrin-1 for predicting the deterioration of neurological function in the early stage of ACH was 0.843(0.732-0.941),and the cut-off value was 412.37 ng·L^(-1),the specificity was 74.28%,and the sensitivity was 84.69%.Multivariate logistic regression analysis showed that high-level netrin-1(OR=2.82,95%CI:1.43-5.57)was an influencing factor of early neurological deterioration in patients with ACH(P<0.05).Conclusion Serum netrin-1 is elevated in patients with ACH,which can be used as one of the potential reference indexes to predict the early neurological deterioration of cerebral hemorrhage and provide a reference for early diagnosis and treatment.