可溶性凝集素样氧化性低密度脂蛋白受体1与动脉瘤性蛛网膜下腔出血预后相关性的研究

doi:10.19854/j.cnki.1008-2425.2023.02.0009

摘要/Abstract

摘要： 目的探讨血清可溶性凝集素样氧化性低密度脂蛋白受体1(soluble lectin-like oxidized low-density lipoprotein receptor-1,sLOX-1)对动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)患者预后评估的价值。方法选取2020年3月至2022年3月就诊于我院神经外科的232例aSAH患者作为分析组,另选取114名健康体检者作为对照组。收集研究对象的一般临床资料、评估记录Hunt-Hess分级、改良Fisher分级、动脉瘤破裂大小,采集入院患者24 h内静脉血检测sLOX-1水平,根据mRS评分量表分析比较预后良好组及不良组各项临床指标,Spearman 相关性检验分析sLOX-1与aSAH病情严重程度的相关性;多因素logistic 回归分析aSAH患者预后的危险因素;采用受试者工作特征曲线(ROC曲线)分析sLOX-1在aSAH患者预后中的评估价值。结果 aSAH组血清sLOX-1 水平明显高于健康对照组(P＜0.05),且预后不良组sLOX-1 水平明显高于预后良好组(P＜0.05)。血清sLOX-1 水平与Hunt-Hess分级及改良Fisher分级呈正相关(P＜0.001)logistic 回归分析结果得出,Hunt-Hess分级(3~5级),动脉瘤大小(≥5 mm),血清sLOX-1浓度和改良Fisher分级(3~4级)是导致aSAH患者术后预后不良的影响因素(P＜0.05),血清sLOX-1评估aSAH患者预后的AUC为 0.739,cutoff值为1.68 ng/ml,灵敏度67.82%特异度76.37%,(Youden指数=0.659;95%CI 0.741～0.902)。结论血清sLOX-1 水平与aSAH患者病情严重程度相关,是预后不良患者的独立影响因素,在aSAH患者疾病严重程度及临床预后评估中具有较高的应用价值。

关键词: 动脉瘤性蛛网膜下腔出血, sLOX-1, 预后, 相关性

Abstract: Objective To investigate the effect of serum soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) on aneurysmal subarachnoid hemorrhage (aSAH) ) value of patient prognosis assessment.Methods A total of 232 aSAH patients who visited our hospital's neurosurgery department from March 2020 to March 2022 were selected as the analysis group,and 114 healthy subjects were selected as the control group.The general clinical data of the research subjects were collected,and the Hunt-Hess grade,modified Fisher grade,and aneurysm rupture size were evaluated and recorded.The venous blood of the patients admitted to the hospital within 24 hours was collected to detect the level of sLOX-1,and the mRS score was used to analyze and compare the good prognosis group and the poor group.For various clinical indicators,Spearman correlation test was used to analyze the correlation between sLOX-1 and the severity of aSAH;multivariate logistic regression was used to analyze the risk factors for the prognosis of patients with aSAH;receiver operating characteristic curve (ROC curve) was used to analyze the relationship between sLOX-1 Evaluation value in the prognosis of aSAH patients.Results The level of serum sLOX-1 in the aSAH group was significantly higher than that in the healthy control group (P＜0.05),and the level of sLOX-1 in the poor prognosis group was significantly higher than that in the good prognosis group (P＜0.05).Serum sLOX-1 level was positively correlated with Hunt-Hess classification and modified Fisher classification (P＜0.001)Logistic regression analysis showed that Hunt-Hess grade (grade 3-5),aneurysm size (≥5 mm),serum sLOX-1 concentration and modified Fisher grade (grade 3-4) were associated with poor postoperative prognosis in patients with aSAH Influencing factors (P＜0.05),The AUC of serum sLOX-1 for evaluating the prognosis of aSAH patients was 0.739,the cutoff value was 1.68 ng/ml,the sensitivity was 67.82%,the specificity was 76.37%,(Youden index=0.659;95% CI 0.741-0.902).Conclusion The level of serum sLOX-1 is related to the severity of aSAH patients,and is an independent influencing factor for patients with poor prognosis.

Key words: Aneurysmal subarachnoid hemorrhage, SLOX-1, Prognosis, Correlation

中图分类号:

R743.35

宋景辉, 林志坤, 王文浩, 黄巍, 胡康, 罗飞. 可溶性凝集素样氧化性低密度脂蛋白受体1与动脉瘤性蛛网膜下腔出血预后相关性的研究[J]. 立体定向和功能性神经外科杂志, 2023, 36(2): 105-109.

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