摘要
目的探讨蛛网膜下腔出血患者血清成纤维细胞生长因子21(FGF21)、补体C1q肿瘤坏死因子相关蛋白9(CTRP9)水平及其对脑血管痉挛(CVS)的预测价值。方法选取2023年6月至2025年3月武汉大学中南医院收治的116例蛛网膜下腔出血患者为研究对象,入院后根据影像学及临床检查结果判定是否发生CVS,分为CVS组(46例)和无CVS组(70例)。另选取同期100例体检健康者为对照组。采用酶联免疫吸附测定法(ELISA)检测血清FGF21、CTRP9水平。多因素Logistic回归分析影响CVS发生的因素;受试者工作特征曲线评估血清FGF21、CTRP9对CVS的预测价值。结果CVS组和无CVS组血清FGF21水平均高于对照组,CTRP9水平均低于对照组(P<0.05);CVS组血清FGF21水平高于无CVS组,CTRP9水平低于无CVS组(P<0.05)。高血压、颅内出血量、费舍尔分级量表(Fisher)分级、FGF21、CTRP9是蛛网膜下腔出血患者发生CVS的影响因素(P<0.05)。血清FGF21、CTRP9联合预测CVS的曲线下面积为0.977,优于二者单独预测(Z=2.958、3.550,P=0.003、0.000)。结论蛛网膜下腔出血合并CVS患者血清FGF21水平升高、CTRP9水平降低,二者联合检测对CVS的发生具有较好的预测价值。
Objective To investigate the levels of serum fibroblast growth factor 21(FGF21)and C1q tumor necrosis factor-related protein 9(CTRP9)in subarachnoid hemorrhage patients and their predictive value for cerebral vasospasm(CVS).Methods A total of 116 patients with subarachnoid hemorrhage admitted to our hospital from June 2023 to March 2025 were collected as the study subjects.After admission,the occurrence of CVS was determined based on imaging and clinical examination results,and the patients were divided into a CVS group(46 cases)and a non-CVS group(70 cases).Another 100 physically examined healthy individuals were selected as control group in the same period.Enzyme linked immunosorbent assay(ELISA)was applied to detect the levels of serum FGF21 and CTRP9.Multivariate logistic regression was applied to analyze the influencing factors of the occurrence of CVS.Receiver operating characteristic curve was applied to evaluate the predictive value of serum FGF21 and CTRP9 for CVS.Results The serum FGF21 levels in the CVS group and the non-CVS group were higher than those in the control group,while their CTRP9 levels were lower than those in the control group(P<0.05).The serum FGF21 level in the CVS group was higher than that in the non-CVS group,and the CTRP9 level was lower than that in the non-CVS group(P<0.05).The intracranial hemorrhage volume,Fisher grade,FGF21,and CTRP9 were the influencing factors for the occurrence of CVS in patients with subarachnoid hemorrhage(P<0.05);the combined prediction of serum FGF21 and CTRP9 for CVS had an area under the curve of 0.977,which was superior to the independent prediction(Z=2.958,3.550,P=0.003,0.000).Conclusions In patients with subarachnoid hemorrhage and CVS,serum FGF21 level is elevated and their CTRP9 level is decreased.The combined detection of the two has good predictive value for the occurrence of CVS.
作者
李文惠
张再罗
吴茜
万蕾
朱沐雨
武远远
施俊
LI Wenhui;ZHANG Zailuo;WU Qian;WAN Lei;ZHU Muyu;WU Yuanyuan;SHI Jun(Department of Neurosurgery,Wuhan University Zhongnan Hospital,Wuhan,Hubei 430000,China)
出处
《中华神经外科疾病研究杂志》
2026年第4期83-87,共5页
Chinese Journal of Neurosurgical Disease Research
基金
湖北卫健委2023-2024年度青年人才项目(WJ2023Q008)。
