血清透明质酸水平预测急性期自发性脑出血患者预后的临床研究

Clinical value of serum hyaluronic acid level in acute stage in predicting the prognosis of patients with spontaneous intracerebral hemorrhage

摘要:

目的 探讨血清透明质酸（HA）在急性自发性脑出血（ICH）发作后的变化及与ICH患者预后的关系。方法 前瞻性收集284例自发性ICH患者为研究对象，记录一般资料、病史、临床资料以及影像学特点等指标；另外收集95例年龄和性别相匹配的健康人作为对照组进行对比分析。采用改良的Rankin量表对患者出院后90 d时情况进行评分，根据评分将患者分为预后良好组和预后不良组，对两组患者进行统计分析。结果 ICH患者血清HA水平高于对照组，差异具有统计学意义（P<0.001）。284例患者中211例患者预后良好，73例患者预后不良；预后不良组患者HA水平（796.1±49.6 ng/mL），明显高于预后良好组的（487.2±42.9 ng/ml），两组比较差异具有统计学意义（P<0.001）。患者HA水平与入院时的NIHSS评分呈正相关关系（r²=0.372， P<0.001）；与治疗后90 d的mRS评分呈正相关关系（r²=0.456， P<0.001）。结论 在急性自发性ICH患者中，HA表达水平明显升高，且入院时高血清HA水平是预后不良的预测因素。

Abstract:

Objective To investigate the change in serum hyaluronic acid (HA) level after the attack of spontaneous intracerebral hemorrhage (ICH) and its association with the prognosis of ICH patients.Methods A total of 284 patients with spontaneous ICH were enrolled in a prospective study,and their general information,medical history,clinical data,and imaging features were collected;95 healthy subjects matched for age and sex were enrolled as control group for comparison.The modified Rankin scale was used to evaluate the patients'conditions at 90 days after discharge,and according to this score,the patients were divided into good prognosis group and poor prognosis group.A statistical analysis was performed for these two groups.Results The ICH group had a significantly higher serum HA level than the control group (P<0.001).Among the 284 patients,211 had good prognosis and 73 had poor prognosis;the poor prognosis group had a significantly higher serum HA level than the good prognosis group (796.1±49.6 ng/ml vs 487.2±42.9 ng/ml,P<0.001).The HA level was positively correlated with the National Institutes of Health Stroke Scale score on admission (r²=0.372,P<0.001) and the modified Rankin Scale score at 90 days after treatment (r²=0.456,P<0.001).Conclusions Patients with acute spontaneous ICH have a significantly increase in HA level,and a high serum HA level on admission is a predictive factor for poor prognosis.