摘要
目的探究血清tau蛋白、巨噬细胞炎性蛋白1α(MIP-1α)和胶质纤维酸性蛋白(GFAP)水平与高血压脑出血后血脑屏障损伤的关系。方法纳入2020年8月至2022年12月阳光融和医院收治的高血压脑出血患者180例作为研究组,选取同期来我院体检的健康人群180例作为对照组。根据白蛋白商值(QAlb)评估患者血脑屏障损伤,将研究组180例患者分为轻度组83例(QAlb 7.5~10)、中度组54例(10<QAlb≤30)、重度度组43例(QAlb>30)。对研究组180例患者展开6个月随访,根据改良的Rankin量表(mRS)评分评估预后,分为预后良好组119例(mRS评分0~2分)和预后不良组61例(mRS评分3~6分)。检测血清tau蛋白、MIP-1α和GFAP水平,分析血清tau蛋白、MIP-1α和GFAP水平与患者血脑屏障损伤和预后的关系。结果研究组血清tau蛋白、MIP-1α和GFAP水平显著高于对照组(P<0.01)。中度组、重度组tau蛋白水平显著高于轻度组,重度组MIP-1α和GFAP水平显著高于轻度组(P<0.05)。预后不良组血清tau蛋白、MIP-1α和GFAP水平显著高于预后良好组(P<0.01)。血清tau蛋白(r=0.532,P=0.000)、MIP-1α(r=0.487,P=0.001)和GFAP(r=0.571,P=0.000)分别与QAlb呈正相关。血清tau蛋白(r=0.507,P=0.000)、MIP-1α(r=0.425,P=0.004)和GFAP(r=0.533,P=0.000)分别与mRS评分呈正相关。ROC曲线分析显示,血清tau蛋白和MIP-1α及GFAP三者联合评估患者预后的曲线下面积为0.848(95%CI:0.787~0.897,P=0.000),显著高于三者单一检测。结论高血压脑出血患者血清tau蛋白、MIP-1α和GFAP水平较健康人群明显升高,与脑出血后血脑屏障损伤程度和预后密切相关。
Objective To explore the relationship between serum levels of tau protein,macrophage inflammatory protein 1α(MIP-1α)and glial fibrillary acidic protein(GFAP)with blood-brain barrier(BBB)injury after hypertensive cerebral hemorrhage.Methods A total of 180 patients with hypertensive cerebral hemorrhage and 180 healthy individuals taking physical examination in our hospital from August 2020 to December 2022 were recruited and assigned into study group and control group,respectively.Serum quotient of albumin(QAlb)was used to evaluate the severity of BBB injury,and the 180 patients in the study group were further divided into mild(QAlb:7.5-10,83 cases),moderate(1030,43 cases)subgroups.All these patients were followed up for 6 months,and according to their modified Rankin Scale(mRS)score,they were assigned into good(mRS score:0-2,119 cases)and poor prognosis(3-6,61 cases)subgroups.The serum levels of tau protein,MIP-1αand GFAP were detected.The relationships of serum tau protein,MIP-1αand GFAP levels with BBB injury and prognosis were analyzed.Results The serum levels of tau protein,MIP-1αand GFAP were significantly higher in the study group than the control group(P<0.01).The tau level in the moderate and severe subgroups was obviously higher than that in the mild subgroup,and the MIP-1αand GFAP levels in the severe subgroup were notably higher than those in the mild subgroup(P<0.05).The poor prognosis subgroup had remarkably higher serum tau,MIP-1αand GFAP levels than the good prognosis subgroup(P<0.01).Serum tau protein(r=0.532,P=0.000),MIP-1α(r=0.487,P=0.001)and GFAP(r=0.571,P=0.000)were positively correlated with QAlb,respectively,and also with mRS score,separately(r=0.507,P=0.000;r=0.425,P=0.004;r=0.533,P=0.000).ROC curve analysis showed that the AUC value of the 3 proteins combined together in predicting prognosis was 0.848(95%CI:0.787-0.897,P=0.000),significantly greater than that of single indicator.Conclusion The levels of serum tau protein,MIP-1αand GFAP are significantly higher in patients with hype
作者
李永华
李萍
张洪红
王志胜
董元
Li Yonghua;Li Ping;Zhang Honghong;Wang Zhisheng;Dong Yuan(Department of Neurosurgery,Sunshine Union Hospital,Weifang 261000,Shandong Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2024年第4期427-430,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
