摘要
目的分析血清Occludin与基底核区脑出血量、严重程度以及认知功能障碍的关系。方法回顾性收集2019年2月~2021年2月于笔者医院首次确诊基底核区脑出血118例患者作为观察组,同期选择健康体检者90例作为对照组。酶联免疫吸附实验(enzyme linked immunosorbent assay,ELISA)检测血清Occludin。结果与对照组比较,观察组血清Occludin显著升高(4.56±1.03ng/ml vs 1.96±0.42ng/ml,P<0.001)。根据出血量将观察组分为<20ml组和20~40ml组,20~40ml组血清Occludin显著高于<20ml组(6.12±1.34ng/ml vs 3.81±1.22ng/ml,P<0.001)。根据美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分标准将观察组分为轻度51例(0~6分)、中度45例(7~15分)和重度22例(≥16分),与轻度患者(3.76±1.02ng/ml)比较,重度(6.03±0.89ng/ml)和中度(5.86±1.1ng/ml)患者血清Occludin显著升高(P<0.001)。治疗90天后应用蒙特利尔认知评估表(Montreal Cognitive Assessment,MoCA)和简易精神状态评价量表(minimental state assessment scale,MMSE)进行认知功能评估,认知功能障碍患者(n=48)比无认知功能障碍患者(n=70)血清Occludin显著升高(6.35±1.64ng/ml vs 3.55±1.19ng/ml,P<0.001)。受试者工作特征(receiver operating characteristic,ROC)曲线显示,血清Occludin评估认知功能障碍的曲线下面积(area under curve,AUC)为0.779,临界值为4.95ng/ml,敏感度为77.5%,特异性为70.9%。多因素Logistic回归分析发现,年龄≥65岁、NIHSS评分≥7分、出血量≥20ml、血清Occludin≥5.0ng/ml是认知功能障碍的独立危险因素(P<0.05)。结论基底核区脑出血患者血清Occludin水平升高与出血量、严重程度以及认知功能障碍密切相关,可作为临床重要生化标志物。
Objective To analyze the relationships between serum occludin and bleeding volume,disease severity degree,cognitive impairmentin patients with basal ganglia intracerebral hemorrhage.Methods A total of 118 patients with basal ganglia intracerebral hemorrhage diagnosis for the first time from February 2019 to February 2021 were retrospectively summarized as the observation group.At the same time,90 healthy people were chosed as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect serum occludin.Results Compared with the control group,serum occludin in observation group was significantly increasing(4.56±1.03ng/ml vs 1.96±0.42ng/ml,P<0.001).Compared with patients of bleeding volume<20ml,serum occludin in patients of bleeding volume 20-40ml was significantly higher in observation group(6.12±1.34ng/ml vs 3.81±1.22ng/ml,P<0.001).According to the National Institutes of Health Stroke Scale(NIHSS)score,the observation group was divided into 51 patients of mild(0-6 points),45 patients of moderate(7-15 points)and 22 patients of severe(≥16 points).Compared with mild patients,serum occludin of moderate and severe patients was significantly higher(6.03±0.89ng/ml,5.86±1.1ng/ml vs 3.76±1.02ng/ml,P<0.001).According to Montreal Cognitive Assessment Scale(MoCA)and mini mental state assessment scale(MMSE)after 90 days of treatment,serum occludin of patients with cognitive impairment(n=48)was significantly higher than patients without cognitive impairment(n=70)(6.35±1.64ng/ml vs 3.55±1.19ng/ml,P<0.001).Receiver operating characteristic(ROC)curve showed that the area under curve(AUC)of serum occludin for cognitive impairment diagnosis was 0.779,and cut-off value was 4.95ng/ml,sensitivity was 77.5%and specificity was 70.9%.Multivariate Logistic regression showed that age≥65 years,NIHSS score≥7,bleeding volume≥20ml and serum occludin≥5.0ng/ml were the independent risk factors to cognitive impairment(P<0.05).Conclusion Higher serum occludin in patients with basal ganglia intracerebral hemorrhage
作者
高明明
崔潘
王瑜
贾文志
郝亮
姚志刚
GAO Mingming;CUI Pan;WANG Yu(Neurosurgery,Shijiazhuang Third Hospital,Hebei 050000,China)
出处
《医学研究杂志》
2022年第12期115-119,共5页
Journal of Medical Research
基金
河北省石家庄市科学技术研究与发展计划项目(191200823)。
