摘要
目的:分析半乳糖凝集素-9(Gal-9)、应激诱导蛋白2(SESN2)在高血压性脑出血(HICH)患者中的表达及对不良预后的预测价值。方法:回顾性选取某院2022年6月—2024年9月收治的91例HICH患者为研究对象,根据病情严重程度分为重度组(n=30)、中度组(n=30)及轻度组(n=31)。比较3组血清Gal-9、SESN2水平及神经功能指标[胶质纤维酸性蛋白(GFAP)、神经元轴突轻链(NF-L)、神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S100β)]水平和预后评分[格拉斯哥昏迷评分(GCS)、格拉斯哥预后评分(GOS)],采用Pearson系数分析血清Gal-9、SESN2与神经功能指标和预后评分的相关性。随访1年,根据患者是否发生不良预后分为预后良好组(n=70)和预后不良组(n=21),比较2组血清Gal-9、SESN2水平,绘制ROC曲线分析血清Gal-9、SESN2对HICH患者不良预后的预测价值。结果:重度组血清Gal-9[(20.35±3.39)ng/L]、SESN2[(18.45±3.23)μg/L]水平高于中度组[(18.66±3.48)ng/L、(16.25±3.47)μg/L]、轻度组[(17.32±3.46)ng/L、(15.25±3.48)μg/L],差异有统计学意义(P<0.05)。重度组血清GFAP、NF-L、NSE、S100β水平高于中度组、轻度组,差异有统计学意义(P<0.05)。重度组GCS、GOS评分低于中度组、轻度组,差异有统计学意义(P<0.05)。相关性分析显示,血清Gal-9、SESN2与GFAP、NF-L、NSE、S100β水平呈正相关(r_(Gal-9)=0.358、0.361、0.357、0.360;r_(SESN2)=0.362、0.363、0.365、0.361,P均<0.05),与GCS、GOS评分呈负相关(r_(Gal-9)=-0.254、-0.252;r_(SESN2)=-0.259、-0.260,P均<0.05)。预后不良组血清Gal-9[(25.35±5.41)ng/L]、SESN2[(20.39±3.41)μg/L]水平高于预后良好组[(20.47±5.39)ng/L、(17.63±3.22)μg/L],差异有统计学意义(P<0.05)。ROC分析显示,血清Gal-9、SESN2预测HICH患者不良预后的AUC为0.870、0.867;联合预测的AUC为0.932,灵敏度为90.48%,特异度为83.29%。结论:血清Gal-9、SESN2与HICH患者神经功能指标呈正相关,与预后评分呈负相关,联合检测其水平能实现对患者不良预后发生风险的早期预测。
Objective:To analyze the association between Gal-9,SESN2 and the progression and prognosis of patients with hypertensive intracerebral hemorrhage(HICH).Methods:A retrospective study was conducted on 91 HICH patients admitted to a hospital from June 2022 to September 2024.Based on the severity of the condition,they were classified into a severe group(30 cases),a moderate group(30 cases),and a mild group(31 cases).Gal-9,SESN2,neurological function serum indicators[glial fibrillary acidic protein(GFAP),neuronal axonal light chain(NF-L),neuron specific enolase(NSE),central nervous system specific protein(S100β)],and prognostic scores[Glasgow Coma Scale(GCS),Glasgow Outcome Scale(GOS)]were compared among the three groups of patients.Pearson correlation coefficient was used and the correlation between Gal-9,SESN2 and patients'neurological function and prognosis was analyzed.ROC curve was plotted to assess the predictive value of serum Gal-9 and SESN2 for poor prognosis in HICH patients.Results:Levels of Gal-9[(20.35±3.39)ng/L]and SESN2[(18.45±3.23)μg/L]in the severe group were both higher than those in the moderate group[(18.66±3.48)ng/L,(16.25±3.47)μg/L]and the mild group[(17.32±3.46)ng/L,(15.25±3.48)μg/L](P<0.05).The GFAP,NF-L,NSE,and S100βlevels in the severe group were higher than those in the moderate group and the mild group(P<0.05).The GCS and GOS of the severe group were lower than those of the moderate group and the mild group(P<0.05).According to Pearson correlation coefficient analysis,Gal-9 was positively correlated with GFAP,NF-L,NSE,S100β,and negatively correlated with GCS and GOS(r=0.358,0.361,0.357,0.360,-0.254,-0.252;P<0.05).SESN2 was positively correlated with GFAP,NF-L,NSE,and S100β,and negatively correlated with GCS and GOS(r=0.362,0.363,0.365,0.361,-0.259,-0.260;P<0.05).According to statistics,the incidence of poor prognosis in 91 HICH patients was 23.08%(21/91).The Gal-9 and SESN2 levels in the poor prognosis group were(25.35±5.41)ng/L and(20.39±3.41)μg/L,respectively,higher than those in the good prognosis group[(20.47±5.39)ng/L,(17.63±3.22)μg/L](P<0.05).According to the ROC test,the combined detection of Gal-9 and SESN2 showed higher sensitivity and specificity in predicting poor prognosis in HICH patients than the detection of Gal-9 and SESN2 alone(AUC=0.932,0.870,0.867).Conclusion:Gal-9 and SESN2 are positively correlated with the neurological function serum indicators of HICH patients,and combined detection of Gal-9 and SESN2 can achieve early prediction of the risk of poor prognosis in patients.
作者
刘梦莹
黄冀
LIU Mengying;HUANG Ji(Department of Trauma and Neurological Intensive Care,Nanyang Central Hospital,Nanyang,Henan 473000,China)
出处
《淮海医药》
2025年第6期556-560,共5页
Journal of Huaihai Medicine
基金
河南省医学科技攻关项目(LHGJ2020102502)。
