血清骨桥蛋白水平与急性脑出血患者病情及预后的关系徐叶1黄思思2.docVIP

血清骨桥蛋白水平与急性脑出血患者病情及预后的关系 徐叶1 黄思思2 何睿瑜1 田慧军3 （1佛山市第一人民医院神经外科，佛山，528000；2 广州中山大学附属第一医院特诊内科，广州，510000；3 北京市解放军第309医院神经内科，北京，100091） 摘要 目的 探讨血清骨桥蛋白（OPN）水平变化与急性脑出血患者病情严重程度及预后的关系。方法 选取急性脑出血患者46例作为观察组，入院后24h内进行NIHSS评分，根据CT计算脑出血体积，另选取同期健康体检者20例为对照组；采用ELISA法分别检测患者入院后1d、7d、14d以及对照组体检当日血清OPN水平，比较不同脑出血量、不同神经功能缺损严重程度患者血清OPN水平的差异；3个月后行改良Rankin量表（MRS）评分评价预后情况。根据MRS评分分为预后良好亚组（MRS评分＜3分）和预后不良亚组（MRS评分≥3分），采用Logistic回归分析影响预后的危险因素。结果 观察组患者血清OPN水平[（7.98±3.22）ng/mL]显著高于对照组[（4.08±2.15）ng/mL]（t=5.366，P=0.000）；脑出血患者入院后1d、7d、14d血清OPN水平随着出血量的增大而逐渐增高（均P＜0.01）；入院后1d、7d、14d血清OPN水平随着神经功能缺损严重程度的加重而逐渐增高（均P＜0.01）；预后不良亚组年龄、hs-CRP、脑出血体积、NIHSS评分、血清OPN水平明显高于预后良好亚组(P＜0.05或0.01)；Logistic回归分析结果显示，入院时NIHSS评分、hs-CRP、OPN水平是影响脑出血患者预后的独立危险因素（均P＜0.05）。结论 脑出血患者血清OPN水平增高，与脑出血量、神经功能缺损严重程度有关，是预后不良的独立危险因素，可为脑出血患者预后判断提供一定的参考依据。 关键词 脑出血；骨桥蛋白；预后 The relationship between seum osteopontin levels and severity and prognosis in acute cerebral hemorrhage Xu Ye1, Huang Si-si2, He Rui-yu1, Tian Hui-jun3(1 Department of Neurosurgery, The First People Hospital of Foshan,Foshan,528000,China; 2 Priority medical service, No.1 Affiliated Hospital of Sun-Yat senUniversity, Guangzhou,510080,China; 3 Department of neurology,The 309th hospital of PLA, Beijing, 100091) Corresponding author: Tian Hui-jun, Email:thj96236@163.com Abstract Objective To explore the relationship between the change of serum osteopontin (OPN) levels and severity and prognosis in acute cerebral hemorrhage. Methods 46 patients with cerebral hemorrhage were selected as the observation group. The observation group was scored by NIHSS socre within 24h admission. According to CT, cerebral hemorrhage volume was calculated. 20 healthy individuals who underwent physical examination during the same period of time were selected as the control group. Serum OPN levels were determined by ELISA on day 1,day 7 and day 14 after admission respectively in the observation group and medical examination day in healthy control. The levels of serum OPN in the patients with different cere