| 姚寅生,叶士露,雷钟奇,丁 鑫,袁 杰.血清ANXA1、dickkopf-1与动脉瘤性蛛网膜下腔出血患者脑损伤程度和预后的关系[J].,2024,(1):111-116 |
| 血清ANXA1、dickkopf-1与动脉瘤性蛛网膜下腔出血患者脑损伤程度和预后的关系 |
| Relationship between Serum ANXA1, dickkopf-1 and the Degree of Brain Injury and Prognosis in Patients with Aneurysmal Subarachnoid Hemorrhage |
| 投稿时间：2023-05-28 修订日期：2023-06-23 |
| DOI：10.13241/j.cnki.pmb.2024.01.021 |
| 中文关键词: 动脉瘤性蛛网膜下腔出血 脑损伤 ANXA1 dickkopf-1 预后 |
| 英文关键词: Aneurysmal subarachnoid hemorrhage Brain injury ANXA1 dickkopf-1 Prognosis |
| 基金项目:安徽省重点研究与开发计划项目（202104j07020002） |
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| 中文摘要: |
| 摘要 目的：探讨动脉瘤性蛛网膜下腔出血（aSAH）患者血清膜联蛋白AI（ANXA1）、dickkopf相关蛋白1（dickkopf-1）水平与脑损伤程度及与预后的关系。方法：选取中国人民解放军联勤保障部队第九〇一医院2018年11月-2021年5月收治的100例aSAH患者作为观察组，选取同期健康体检者101例作为对照组。检测两组血清ANXA1、dickkopf-1水平，比较两组血清ANXA1、dickkopf-1水平差异。分析血清ANXA1、dickkopf-1水平与aSAH患者脑损伤程度和手术治疗后预后的关系。结果：观察组血清ANXA1水平低于对照组（P<0.05），dickkopf-1水平高于对照组（P<0.05）。Spearman相关性分析显示，血清ANXA1与Hunt-Hess评分、WFNS评分和改良Fisher评分呈负相关（P<0.05）；血清dickkopf-1与Hunt-Hess评分、WFNS评分和改良Fisher评分均呈正相关（P<0.05）。所有患者均随访半年，经统计术后预后不良患者有56例，预后不良发生率为56%。多因素Logistic回归分析显示，高ANXA1水平为aSAH患者预后不良的保护因素（P<0.05）；高dickkopf-1水平、高Hunt-Hess评分、高WFNS评分、高改良Fisher评分是aSAH患者预后不良的危险因素（P<0.05）。ROC曲线分析显示：联合血清ANXA1、dickkopf-1及Hunt-Hess评分、WFNS评分、改良Fisher评分对aSAH患者预后的评估价值最高，ROC-AUC（0.95CI）为0.843(0.748～0.942)。结论：aSAH患者血清ANXA1、dickkopf-1水平与脑损伤程度密切相关，是患者预后不良的影响因素。联合血清ANXA1、dickkopf-1与病情评分对aSAH患者预后具有较高的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum Annexin AI (ANXA1), dickkopf related proteins-1 (dickkopf-1) levels and the degree of brain injury and prognosis in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods: 100 patients with aSAH admitted to The 901 Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from Nov 2018 to May 2021 were selected as the observation group, and 101 healthy physical examination were selected as the control group during the same period. The serum ANXA1, dickkopf-1 levels of two groups were detected, and the differences in serum ANXA1, dickkopf-1 levels between the two groups were compared. The relationship between serum ANXA1, dickkopf-1 levels and the degree of brain injury and the prognosis after surgical treatment in patients with aSAH were analyzed. Results: The level of serum ANXA1 in the observation group was lower than that in the control group(P<0.05), while the dickkopf-1 level wsa higher than that in the control group (P<0.05). Spearman correlation analysis showed that, serum ANXA1 was negatively correlated with Hunt-Hess score, WFNS score and Modified Fisher score (P<0.05); Serum dickkopf-1 was positively correlated with Hunt-Hess score, WFNS score and Modified Fisher score (P<0.05). All patients were followed up for half a year, there were 56 patients with poor prognosis after surgery according to statistics, and the incidence of poor prognosis was 56%. Multivariate logistic regression analysis showed that, high ANXA1 level was protective factor for poor prognosis in patients with aSAH(P<0.05); high Dickkopf-1 level, high Hunt-Hess score, high WFNS score, high Modified Fisher score were risk factors for poor prognosis in patients with aSAH(P<0.05). ROC curve analysis showed that, the combination of serum ANXA1, Dickkopf-1 and Hunt-Hess score, WFNS score, and Modified Fisher score had the highest prognostic value in patients with aSAH, ROC-AUC (0.95CI) was 0.843(0.748～0.942). Conclusion: The levels of serum ANXA1 and dickkopf-1 in patients with aSAH were closely related to the degree of brain injury , and were influence factors for poor prognosis in patients with aSAH. The combination of serum ANXA1, dickkopf-1 with disease score had high evaluation value for the prognosis of patients with aSAH. |
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