摘要
目的探讨血清可溶性Fms样酪氨酸激酶1(sFlt-1)水平对自发性蛛网膜下腔出血(SAH)并发脑血管痉挛(CVS)的预测价值。方法选择自发性SAH患者115例,入院3~5 d并发CVS 44例(CVS组)、未并发CVS 71例(对照组)。比较两组一般临床资料(包括性别、年龄、BMI,吸烟史、饮酒史,糖尿病、高血压、高脂血症、冠心病等基础疾病及发病至入院时间)、疾病相关资料[包括入院时格拉斯哥昏迷评分(GCS)、发热持续时间、血压波动持续时间、颅内出血量(经CT估算)、Hunt-Hess分级、Fisher分级]、实验室检查资料[包括WBC计数、Hb、空腹血糖(FPG)、sFlt-1]。采用多因素Logistic回归分析自发性SAH并发CVS的独立危险因素。采用受试者工作特征(ROC)曲线评估血清sFlt-1水平对自发性SAH并发CVS的预测价值。结果在一般临床资料中,两组有吸烟史及合并糖尿病、高血压比例比较P均<0.05;在疾病相关资料中,两组入院时GCS、血压波动持续时间、颅内出血量、Hunt-Hess分级、Fisher分级比较P均<0.05;在实验室检查资料中,两组WBC计数、Hb、FPG、sFlt-1比较P均<0.05。多因素Logistic回归分析显示,颅内出血量、Fisher分级、sFlt-1是自发性SAH并发CVS的独立危险因素(P均<0.01)。ROC曲线分析显示,血清sFlt-1水平预测自发性SAH并发CVS的曲线下面积为0.726(95%CI:0.624~0.827),最佳截断值为119.35 ng/L,此时其预测自发性SAH并发CVS的敏感性为75.00%、特异性为77.46%。结论血清sFlt-1水平是自发性SAH并发CVS的独立危险因素,可作为自发性SAH并发CVS的预测指标之一。
Objective To investigate the predictive value of serum soluble Fms-like tyrosine kinase 1(sFlt-1)for spontaneous subarachnoid hemorrhage(SAH)complicated with cerebral vasospasm(CVS).Methods Totally 115 patients with spontaneous SAH were selected,including 44 patients with concurrent CVS(CVS group)and 71 patients without concurrent CVS(control group)within 3-5 days after admission.The general clinical data(including gender,age,BMI,smoking history,drinking history,diabetes,hypertension,hyperlipidemia,coronary heart disease and other basic diseases and onset to admission time),disease related data[including Glasgow coma scale(GCS)on admission,fever duration,blood pressure fluctuations duration,intracranial hemorrhage volume(CT estimate),Hunt-Hess classification and Fisher classification]and laboratory examination data[including the WBC,Hb,fasting blood glucose(PFG),sFlt-1]of the two groups were compared.Multivariate Logistic regression was used to analyze the independent risk factors of spontaneous SAH complicated with CVS.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum sFlt-1 for the occurrence of CVS in spontaneous SAH patients.Results In the general clinical data,significant differences were found in the number of patients with smoking history,diabetes and hypertension between these two groups(all P<0.05).Among the disease-related data,significant differences were found in GCS at admission,blood pressure fluctuation duration,intracranial hemorrhage volume,Hunt-Hess classification,and Fisher classification between these two groups(all P<0.05).In laboratory examination data,significant differences were found in WBC count,Hb,PFG and sFlt-1 between these two groups(all P<0.05).Multivariate Logistic regression analysis showed that intracranial hemorrhage volume,Fisher classification,and sFlt-1 were independent risk factors for spontaneous SAH complicated with CVS(all P<0.01).ROC curve analysis showed that the area under the curve of serum sFlt-1 in predicting spontane
作者
雷源标
雷瑜
欧福勇
易继平
LEI Yuanbiao;LEI Yu;OU Fuyong;YI Jiping(Chenzhou First People's Hospital,Chenzhou 423000,China)
出处
《山东医药》
CAS
2020年第22期31-34,共4页
Shandong Medical Journal
基金
湖南省自然科学基金项目(2016JJ6102)。
