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| 脑脊液TREM-1、MCP-1与动脉瘤性蛛网膜下腔出血患者手术治疗转归的关系 |
| Relationship Between TREM-1 and MCP-1 in Cerebrospinal Fluid and the Outcome of Surgical Treatment in Patients With Aneurysmal Subarachnoid Hemorrhage |
| 投稿时间：2024-06-05 修订日期：2024-06-05 |
| DOI： |
| 中文关键词: 动脉瘤性蛛网膜下腔出血 髓样细胞触发受体-1 单核细胞趋化蛋白-1 术后转归 |
| 英文关键词: Aneurysmal subarachnoid hemorrhage Triggering receptor expressed on myeloid cells-1 Monocyte chemotactic protein-1 Postoperative outcome |
| 基金项目:河南省医学科技攻关计划项目（RKX202202032） |
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| 中文摘要: |
| 目的 探讨脑脊液髓样细胞触发受体-1（TREM-1）、单核细胞趋化蛋白-1（MCP-1）与动脉瘤性蛛网膜下腔出血（aSAH）患者手术治疗转归的关系。方法 选择2021年2月至2023年11月我院收治的294例aSAH患者，所有患者接受动脉瘤栓塞术或手术夹闭治疗，术前检测脑脊液TREM-1、MCP-1水平。出院后随访3个月，采用改良Rankin量表（mRS）评估患者预后，并据此将患者分为转归不良组（103例）和转归良好组（191例）。多因素Logistic回归分析影响aSAH术后转归不良的因素。受试者工作特征（ROC）曲线分析脑脊液TREM-1、MCP-1单独以及联合预测aSAH术后转归不良的价值。结果 转归不良组脑脊液TREM-1、MCP-1水平均高于转归良好组（P＜0.05）。Hunt-Hess分级Ⅲ～Ⅳ级、并发迟发性脑缺血、TREM-1升高、MCP-1升高是aSAH术后转归不良的危险因素（P＜0.05）。脑脊液TREM-1、MCP-1单独预测aSAH术后转归的曲线下面积为0.816、0.837，联合预测曲线下面积为0.941，高于单独预测。结论 aSAH术后转归不良患者血清TREM-1、MCP-1水平升高，是aSAH术后转归不良的危险因素。TREM-1、MCP-1可为aSAH术后转归提供参考。 |
| 英文摘要: |
| Objective To investigate the relationship between triggering receptor expressed on myeloid cells-1 (TREM-1) and monocyte chemoattractant protein-1 (MCP-1) in cerebrospinal fluid and the outcome of surgical treatment in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods 294 patients with aSAH admitted to our hospital from February 2021 to November 2023 were selected, all patients received aneurysm embolization or surgical clipping, the levels of TREM-1 and MCP-1 in cerebrospinal fluid were detected before operation. 3 months after discharge, patient outcomes were assessed using the modified Rankin scale (mRS), and patients were divided into poor outcome group (103 cases) and good outcome group (191 cases) according to this. The factors affecting the poor outcome after aSAH were analyzed by multivariate logistic regression analysis. The value of cerebrospinal fluid TREM-1 and MCP-1 alone and in combination in predicting poor outcome after aSAH were analyzed by receiver operating characteristic (ROC) curve. Results The levels of TREM-1 and MCP-1 in cerebrospinal fluid in poor outcome group were higher than those in good outcome group (P<0.05). Hunt-Hess grade III~IV, delayed cerebral ischemia, increased TREM-1 and MCP-1 were risk factors for poor outcome after aSAH. (P<0.05). The area under the curve of cerebrospinal fluid TREM-1 and MCP-1 alone to predict the postoperative outcome of aSAH was 0.816 and 0.837, respectively, and the combined prediction was 0.941, which was higher than that of single prediction. Conclusion The increase of serum TREM-1 and MCP-1 levels in patients with poor outcome after aSAH are risk factor for poor outcome after aSAH.TREM-1 and MCP-1 can provide a reference for the postoperative outcome of aSAH. |
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