动脉瘤性蛛网膜下腔出血病人血清sTREM-1、PTX3水平及其与病人预后的关系

    Levels of serum sTREM-1 and PTX3 in patients with aneurysmal subarachnoid hemorrhage and their relationship with patients’ prognosis

    • 摘要:
      目的: 分析动脉瘤性蛛网膜下腔出血(aSHA)病人血清可溶性髓系细胞触发受体-1(sTREM-1)、正五聚蛋白3(PTX3)水平及其与病人预后的关系。
      方法: 选取aSHA病人290例作为观察组,体检健康者300名作为对照组。根据改良Rankin量表将aSHA病人分为预后良好组204例和预后不良组86例。以酶联免疫吸附法检测血清sTREM-1、PTX3水平;绘制ROC曲线评估血清sTREM-1、PTX3水平对aSHA病人预后的预测价值;采用多因素logistic回归分析评价aSHA病人预后的影响因素。
      结果: 观察组病人血清sTREM-1、PTX3水平均明显高于对照组(P < 0.01)。预后不良组病人Fisher分级(3 ~ 4)、Hunt-Hess分级(Ⅲ ~ Ⅳ)、再次破裂、脑血管痉挛、脑积水比例及血清sTREM-1、PTX3水平均高于预后良好组(P < 0.05 ~ P < 0.01)。血清sTREM-1、PTX3水平单独及联合预测aSHA病人预后不良的AUC分别为0.826、0.766、0.913,sTREM-1联合PTX3的AUC高于二者单独预测。多因素logistic回归分析显示,Fisher分级、Hunt-Hess分级、再次破裂、脑血管痉挛及血清sTREM-1、PTX3水平均为影响aSHA病人预后不良的独立危险因素(P < 0.05 ~ P < 0.01)。
      结论: sTREM-1、PTX3水平在aSHA病人血清中均呈高表达,与病人预后关系密切,可能作为评估病人预后的潜在指标。

       

      Abstract:
      Objective To analyze the levels of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and pentraxin 3 (PTX3) in patients with aneurysmal subarachnoid hemorrhage (aSHA) and their relationship with the prognosis of patients.
      Methods A total of 290 patients with aSHA were selected as the observation group, and 300 health examinees were selected as the control group. According to the modified Rankin scale (mRS), the aSHA patients were divided into a good prognosis group (n = 204) and a poor prognosis group (n = 86). Enzyme-linked immunosorbent assay was used to detect the levels of serum sTREM-1 and PTX3, ROC curve was drawn to evaluate the predictive value of serum sTREM-1 and PTX3 levels for the prognosis of aSHA patients, and multivariate logistic regression analysis was applied to evaluate the influencing factors for the prognosis of aSHA patients.
      Results The levels of serum sTREM-1 and PTX3 in the observation group were significantly higher than those in the control group (P < 0.01). The proportion of Fisher grade (3-4), Hunt-Hess grade (Ⅲ-Ⅳ), re-rupture, cerebral vasospasm, hydrocephalus, and the levels of serum sTREM-1 and PTX3 in the poor prognosis group were higher than those in the good prognosis group (P < 0.05 to P < 0.01). The AUC of predicting poor prognosis in aSHA patients by serum sTREM-1 and PTX3 levels alone and in combination were 0.826, 0.766, and 0.913, respectively, and the AUC of sTREM-1 combined with PTX3 was higher than that predicted by both alone. Multivariate logistic regression analysis showed that Fisher grade, Hunt-Hess grade, re-rupture, cerebral vasospasm, and levels of serum sTREM-1 and PTX3 were independent risk factors for poor prognosis in aSHA patients (P < 0.05 to P < 0.01).
      Conclusions The levels of sTREM-1 and PTX3 levels are highly expressed in the serum of aSHA patients, are closely related to the prognosis of patients, and may be used as potential indicators for evaluating the prognosis of patients.

       

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