[1]王小卫,王荣辉,刘　龙,等.脑室出血患者血清PTX3，HPA及Adropin蛋白表达水平与微创锥颅软通道引流术预后的相关性研究[J].现代检验医学杂志,2022,37(02):48-53.[doi:10.3969/j.issn.1671-7414.2022.02.010]
　WANG Xiao-wei,WANG Rong-hui,LIU Long,et al.Research on the Correlation between Serum PTX3, HPA and Adropin Protein Expression Levels in Patients with Ventricular Hemorrhage and Prognosis after Minimally Invasive Cranial Soft Channel Drainage[J].Journal of Modern Laboratory Medicine,2022,37(02):48-53.[doi:10.3969/j.issn.1671-7414.2022.02.010]
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脑室出血患者血清PTX3，HPA及Adropin蛋白表达水平与微创锥颅软通道引流术预后的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年02期
页码:
48-53
栏目:
论　著
出版日期:
2022-03-15

文章信息/Info

Title:
Research on the Correlation between Serum PTX3, HPA and Adropin Protein Expression Levels in Patients with Ventricular Hemorrhage and Prognosis after Minimally Invasive Cranial Soft Channel Drainage
文章编号:
1671-7414（2022）02-048-06
作者:
王小卫; 王荣辉; 刘　龙; 吴力娟; 周西广
（邢台市第三医院神经外四科，河北邢台 054000）
Author(s):
WANG Xiao-wei;  WANG Rong-hui;  LIU Long;  WU Li-juan;  ZHOU Xi-guang
（the Fourth Department of Neurology, Xingtai Third Hospital, Hebei Xingtai 054000, China）
关键词:
正五聚蛋白3; 乙酰肝素酶; Adropin蛋白; 脑室出血; 微创锥颅软通道引流术
分类号:
R743.34；R392.11
DOI:
10.3969/j.issn.1671-7414.2022.02.010
文献标志码:
A
摘要:
目的　探讨血清正五聚蛋白3(pentraxin 3, PTX3)，乙酰肝素酶(heparinase, HPA) 及Adropin 蛋白的表达水平与脑室出血患者微创锥颅软通道引流术后预后的关系。方法　选择2019 年10 月～ 2020 年5 月邢台市第三医院收治的122 例脑室出血患者作为观察组，同时选取同期60 例健康志愿者为对照组，检测两组受试者血清PTX3，HPA和Adropin 蛋白表达。所有患者均行脑室出血微创软通道引流术，收集患者年龄、性别、脑出血量、发病至手术时间及术前血液学指标等基线资料。随访3 个月，应用改良版Rankin 量表评估患者预后情况，分成预后良好组和预后不良组。单因素和多因素Logistic 回归分析确定血清PTX3，HPA 和Adropin 蛋白确定脑室出血患者微创锥颅软通道引流术后预后不良的关系。结果　观察组患者血清PTX3(14.78±2.02ng/ml vs 7.89±1.87ng/ml) 和HPA(4.08±0.98ng/ml vs 2.01±0.50ng/ml) 水平明显高于对照组，差异具有统计学意义(t=22.157,18.866, 均P<0.001)。观察组患者血清Adropin 蛋白明显低于对照组(1.87±0.22μg/ml vs 3.70±0.35μg/ml)，差异具有统计学意义(t=37.060, P<0.001)。预后良好组患者血清PTX3(13.64±3.36ng/ml vs 16.98±3.72ng/ml) 和HPA(3.36±0.87ng/ml vs 4.97±1.01ng/ml) 明显低于预后不良组，差异具有统计学意义(t=5.010, 9.144, 均P<0.001)。血清Adropin 蛋白明显高于预后不良组(2.39±0.42μg/ml vs 1.30±0.28μg/ml)，差异具有统计学意义(t=16.932, P<0.001)。根据ROC 曲线可得，PTX3，HPA和Adropin 蛋白诊断的最佳临界值分别为15.01ng/ml，3.82ng/ml 和1.85μg/ml，对应的敏感度、特异度和AUC 分别为67.44%，69.74% 和0.798(95%CI:0.748~0.851)；65.12%，71.05% 和0.760(95%CI:0.707~0.812)；60.46%，60.53% 和0.631(95%CI:0.567~0.0.698)。预后良好组和预后不良组的患者在年龄、高血压、高血糖、脑出血量、病情严重程度、发病至手术时间、二次手术及PTX3，HPA，Adropin 等差异均有统计学意义(χ2=16.937, 8.848, 8.567, 10.301, 15.899, 7.461,4.015, 13.223, 10.976, 16.158, P<0.05)。Logistic 回归分析结果显示年龄(OR=1.655, 95%CI:1.355~2.022)、病情严重程度(OR=1.565, 95%CI:1.056~2.321)、高血压(OR=1.835, 95%CI:1.015~3.317)、出血量(OR=1.650, 95%CI:1.098~2.481)、PTX3(OR=2.435, 95%CI: 2.045~2.899)、HPA(OR=2.465, 95%CI: 2.018~3.010) 及Adropin 蛋白(OR=2.418, 95%CI: 1.972 ~2.965) 均是患者预后不良的独立影响因素(P<0.05)。结论　脑室出血患者血清PTX3，HPA 和Adropin 蛋白呈现异常表达，且是微创锥颅软通道引流术后预后不良的独立影响因素。
Abstract:
Objective　To explore the research on the relationship between serum PTX3, HPA and Adropin protein expression levels and poor prognosis after minimally invasive skull soft channel drainage in patients with ventricular hemorrhage. Methods　A total of 122 patients with ventricular hemorrhage admitted to the Third Hospital of Xingtai City from October 2019 to May 2020 were selected as the observation group. 60 healthy volunteers who underwent physical examination in the hospital during the same period were randomly selected as the control group. Serum PTX3, HPA and Adropin expression of the two groups were detected. All patients received minimally invasive skull soft channel drainage. Baseline data including age, gender, amount of cerebral hemorrhage, onset to operation time and preoperative hematological indicators were collected. All patients were followed up, the modified Rankin Scale was used to evaluate the prognosis of the patients, and the patients were divided into good prognosis group and poor prognosis group. Univariate and multivariate Logistic regression analysis was used to determine the relationship between serum PTX3, HPA and Adropin protein and the poor prognosis of ventricular hemorrhage. Results　The serum levels of PTX3 (14.78±2.02ng/ml vs 7.89±1.87ng/ml) and HPA(4.08±0.98ng/ml vs 2.01±0.50ng/ml) in observation group were significantly higher than those in control group, the difference was statistically significant(t=22.157,18.866, all P<0.001). The serum Adropin protein in observation group was significantly lower than that in control group(1.87±0.22μg/ml vs 3.70±0.35μg/ml), the difference was statistically significant (t=37.060, P<0.001). Serum PTX3 (13.64±3.36ng/ml vs 16.98±3.72ng/ml) and HPA(3.36±0.87ng/ml vs 4.97±1.01ng/ml) in the good prognosis group were significantly lower than those in the poor prognosis group, the difference was statistically significant(t=5.010, 9.144, P<0.001).Serum Adropin protein was significantly higher than that in the poor prognosis group (2.39±0.42μg/ml vs 1.30±0.28μg/ml), the difference was statistically significant(t=16.932, P<0.001). According to the ROC curve, the optimal cut-off values for PTX3, HPA and Adropin protein diagnosis were 15.01ng/ ml, 3.82ng/ml and 1.85μg/ml, respectively. The corresponding sensitivity, specificity and AUC were 67.44%, 69.74% and 0.798 (95% CI: 0.748~0.851); 65.12%, 71.05%, and 0.760 (95% CI: 0.707~0.812); 60.46%, 60.53% and 0.631 (95% CI: 0.567~0.0.698). There were significant differences in age, hypertension, hyperglycemia, amount of cerebral hemorrhage, severity of the disease, onset to operation time, second operation and PTX3, HPA, Adropin between the good group and the poor group (χ2=16.937, 8.848, 8.567, 10.301, 15.899, 7.461, 4.015, 13.223, 10.976, 16.158, all P<0.05). Logistic regression analysis showed that age (OR=1.655, 95%CI: 1.355~2.022), severity of disease (OR=1.565, 95%CI: 1.056~2.321), hypertension (OR=1.835, 95%CI: 1.015~3.317), blood loss (OR=1.650, 95%CI: 1.098~2.481), PTX3(OR=2.435, 95%CI: 2.045~2.899), HPA(OR=2.465, 95%CI: 2.018~3.010) and Adropin protein (OR=2.418, 95%CI: 1.972~2.965) were independent influencing factors for poor prognosis of patients (P<0.05). Conclusion　Serum PTX3, HPA and Adropin proteins were abnormally expressed in patients with ventricular hemorrhage, and they were independent influencing factors for poor prognosis after minimally invasive conical cranial soft channel drainage.

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备注/Memo

备注/Memo:
基金项目：邢台市科技计划项目（2019ZC224）。
作者简介：王小卫（1983-），男，医学硕士，副主任医师，主要从事脑血管病外科治疗，Email:wxw3198@126.com。
更新日期/Last Update: 1900-01-01