摘要
目的探讨血清血小板源性生长因子(platelet-derived growth factor,PDGF)与脑出血微创穿刺治疗短期预后之间的关系。方法回顾性分析2016年1月至2019年6月在我院接受微创穿刺治疗的118例急性脑出血患者研究资料,并以108例健康体检者作为对照。比较两组研究对象的血清PDGF表达水平。同时收集患者年龄、性别、脑出血量、脑室积血量、发病距手术时长、二次手术、入院时格拉斯哥昏迷评分(GCS)、中线移位等临床信息,并采用改良Rankin量表(mRS)评分对患者术后3个月预后情况进行评估。同时对影响患者术后3个月预后影响因素进行单因素分析和Logistic回归分析,采用受试者工作特征曲线(receiver operating characteristic curve,ROC)研究患者术前PDGF表达水平对患者短期预后的预测价值。结果研究组患者血清PDGF表达水平显著高于对照组,差异具有统计学意义(P<0.001)。根据3个月mRS评分分为预后良好组75例和预后不良组43例,单因素分析结果表明,术前收缩压、术前血糖、发病至手术时长、术前GCS评分、出血部位、出血量、是否发生中位移位和脑部积血、是否二次手术、血清PDGF水平均对术后短期预后具有显著影响(P值<0.05或P<0.001);Logistic回归分析结果显示年龄(OR=4.297,95%CI 2.139~8.634)、出血量(OR=10.612,95%CI 3.647~30.833)、术前GCS评分(OR=10.676,95%CI 2.975~38.318)、发病至手术时长(OR=6.417,95%CI 2.515~16.377)、二次手术(OR=8.891,95%CI 3.637~21.731)、血清PDGF(OR=25.946,95%CI 6.452~104.334)是影响患者术后预后的独立影响因素;PDGF截断值为521.23ng/L,0.701(95%CI:0.558~0.844),灵敏度为62.79%,特异度为61.33%。结论脑出血患者血清PDGF表达水平显著高于健康人群,且其表达水平对脑出血患者行微创穿刺治疗后短期预后具有较高的预测价值。
Objective To investigate the relationship between serum platelet-derived growth factor(PDGF)and the short-term prognosis of minimally invasive treatment of cerebral hemorrhage.Methods A retrospective analysis was conducted on the research data of 118 patients with acute cerebral hemorrhage who received minimally invasive puncture in our hospital from January 2016 to June 2019,and 108 healthy patients were used as controls.Accurately collect clinical information such as patient age,gender,cerebral hemorrhage volume,intraventricular hemorrhage volume,duration of surgery,secondary surgery,Glasgow coma score(GCS),midline shift at admission,and compare serum PDGF expression between the two groups of subjects level,and the modified Rankin Scale(mRS)score was used to evaluate the prognosis of patients at 3 month after surgery.At the same time,the univariate analysis and Logistic regression analysis were performed on the influential factors affecting the prognosis of patients for 3 month after operation.The receiver operating characteristic curve(ROC)was used to study the predictive value of PDGF expression level before surgery on short-term prognosis.Results The serum PDGF expression level in the study group was significantly higher than that in the control group,and the difference was statistically significant(P<0.001);Among 118 patients,they were divided into 75 patients with good prognosis and 43 patients with poor prognosis according to the 3 months mRS score.The univariate analysis showed that preoperative systolic blood pressure,preoperative blood glucose,onset to operation time,preoperative GCS score,and bleeding The location,the amount of bleeding,whether there is a mid-position displacement and cerebral hemorrhage,whether it is a second operation,and the level of serum PDGF have significant effects on short-term prognosis(P value<0.05 or P<0.001);Logistic regression analysis showed age(OR=4.297,95%CI 2.139~8.634),blood loss(OR=10.612,95%CI 3.647~30.833),preoperative GCS score(OR=10.676,95%CI 2.975~38.318),Durat
作者
纪延伟
潘强
殷长江
冯肖亚
赵思任
刘磊
张帅
Ji Yanwei;Pan Qiang;Yin Changjiang(Shandong Provincial Third Hospital neurosurgery1,Neurology2,ShanDong JiNan 250031)
出处
《立体定向和功能性神经外科杂志》
2020年第3期180-185,共6页
Chinese Journal of Stereotactic and Functional Neurosurgery
基金
山东省医药卫生科技发展计划项目(编号:2017WS204)
山东省医药卫生科技发展计划项目(编号:2017WS645)
关键词
脑出血
微创穿刺治疗
血小板源性生长因子
短期预后
影响因素
Cerebral hemorrhage
Minimally invasive puncture treatment
Platelet-derived growth factor
Short-term prognosis
Influencing factors ed growth factors
