摘要
目的探讨血清视锥蛋白样蛋白-1(VILIP-1)、陷窝蛋白-1(Cav-1)对早期高压氧治疗重度颅脑损伤(SCI)患者预后的预测价值。方法选取2021年10月至2024年6月在邯郸市中心医院接受早期高压氧治疗的150例SCI患者作为研究对象。随访半年后采用格拉斯哥预后量表(GOS)评分对患者预后进行评价,并分为良好组109例(GOS评分4~5分)和不良组41例(GOS评分1~3分)。采用受试者工作特性(ROC)曲线评估血清VILIP-1、Cav-1对早期高压氧治疗SCI患者预后的预测价值;采用多因素Logistic逐步回归分析探讨早期高压氧治疗SCI患者预后的影响因素。结果不良组血清VILIP-1、Cav-1水平高于良好组(P<0.05)。血清VILIP-1、Cav-1及二者联合预测早期高压氧治疗SCI患者预后的曲线下面积(AUC)(95%CI)分别为0.856(0.803~0.909)、0.744(0.692~0.796)、0.904(0.852~0.956)。不良组年龄≥60岁、合并高血压、蛛网膜下腔出血、环池消失、中线移位≥5 mm所占比例均大于良好组,C反应蛋白水平高于良好组,受伤至入院时间长于良好组,入院时GCS评分、血小板计数低于良好组(P<0.05)。多因素分析显示,入院时GCS评分低(OR=0.485,95%CI:0.343~0.685)、蛛网膜下腔出血(OR=1.891,95%CI:1.376~2.597)、中线移位≥5 mm(OR=2.547,95%CI:1.691~3.837)、VILIP-1高表达(OR=3.028,95%CI:1.903~4.819)、Cav-1高表达(OR=2.502,95%CI:1.664~3.761)是早期高压氧治疗SCI患者预后不良的危险因素(P<0.05)。结论血清VILIP-1、Cav-1水平升高与早期高压氧治疗SCI患者预后不良有关,且这2项指标可作为预测患者预后的重要标记物。
Objective To explore the predictive value of serum visinin-like protein-1(VILIP-1)and caveolin-1(Cav-1)for the prognosis of patients with severe craniocerebral injury(SCI)treated with early hyperbaric oxygen therapy.Methods A total of 150 SCI patients who received early hyperbaric oxygen therapy from October 2021 to June 2024 were selected.After a 6-month follow-up,the prognosis of the patients was evaluated using the Glasgow Outcome Scale(GOS),and they were divided into a good group(109 patients,GOS score 4-5)and a poor group(41 patients,GOS score 1-3).The predictive value of serum VILIP-1 and Cav-1 for the prognosis of SCI patients treated with early hyperbaric oxygen therapy was evaluated using ROC.The influencing factors on the prognosis of SCI patients treated with early hyperbaric oxygen therapy were explored using multivariate Logistic stepwise regression analysis.Results The serum levels of VILIP-1 and Cav-1 in the poor group were higher than those in the good group(P<0.05).The area under the curve(AUC)(95%CI)of serum VILIP-1,Cav-1,and their combination for predicting the prognosis of SCI patients treated with early hyperbaric oxygen therapy were 0.856(0.803-0.909),0.744(0.692-0.796),and 0.904(0.852-0.956)respectively.The proportion of patients in the poor group with age≥60 years,hypertension,subarachnoid hemorrhage,disappearance of the cisterna magna,and midline shift≥5 mm was higher than that in the good group,and the C-reactive protein level was higher,the time from injury to admission was longer,and the GCS score and platelet count at admission were lower than those in the good group(P<0.05).Multivariate analysis showed that low GCS score at admission(OR=0.485,95%CI:0.343-0.685),subarachnoid hemorrhage(OR=1.891,95%CI:1.376-2.597),midline shift≥5 mm(OR=2.547,95%CI:1.691-3.837),high expression of VILIP-1(OR=3.028,95%CI:1.903-4.819),and high expression of Cav-1(OR=2.502,95%CI:1.664-3.761)were risk factors for poor prognosis in SCI patients treated with early hyperbaric oxygen therapy(P<0.05).Conclusions Elevated levels of serum VILIP-1 and Cav-1 are associated with poor prognosis in SCI patients treated with early hyperbaric oxygen therapy,and these two indicators can be used as important markers for prognosis predicting.
作者
刘冰
霍会永
刘佳佳
刘超
张文超
雷建华
陈名超
LIU Bing;HUO Huiyong;LIU Jiajia;LIU Chao;ZHANG Wenchao;LEI Jianhua;CHENMingchao(Department of Neurology,Handan Central Hospital,Handan,Hebei 056000,China;Department of Neurosurgery,Handan Central Hospital,Handan,Hebei 056000,China;Department of Critical Care Medicine,Affiliated Hospital of Hebei University of Engineering,Handan,Hebei 056000,China)
出处
《中华神经外科疾病研究杂志》
2025年第3期103-107,共5页
Chinese Journal of Neurosurgical Disease Research
基金
河北省医学科学研究课题计划项目(20241660)。
