cFN、Alb/HbA1c、IFN-γ在创伤性脑出血SLTC术患者围术期动态变化及与神经功能的相关性研究

doi:10.3969/j.issn.1671-7171.2021.04.012

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摘要 【目的】 探讨细胞纤维连接蛋白(cFN)、白蛋白(Alb)/糖化血红蛋白(HbA1c)、干扰素-γ(IFN-γ)在创伤性脑出血标准大骨瓣减压术(SLTC)患者围术期动态变化及与神经功能的相关性。【方法】 选取2017年5月至2020年2月本院收治的219例拟行SLTC术创伤性脑出血患者,根据术后30 d预后分为预后良好组(n=107)和预后不良组(n=112)。比较两组术前及术后3 d、7 d血清cFN、Alb/HbA1c、IFN-γ水平,美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷评分法(GCS)评分,采用Pearson分析cFN、Alb/HbA1c、IFN-γ与GCS评分、NIHSS评分的相关性,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析cFN、Alb/HbA1c、IFN-γ预测预后的效能。【结果】 两组患者不同时间血清cFN、Alb/HbA1c、IFN-γ水平及GCS评分、NIHSS评分与术前比较,差异有统计学意义(P<0.05);术后3 d、7 d,两组患者血清cFN、Alb/HbA1c、IFN-γ水平及GCS评分、NIHSS评分比较,差异有统计学意义(P<0.05)。术后3 d、7 d血清cFN、Alb/HbA1c、IFN-γ水平与对应的GCS评分、NIHSS评分均呈显著相关性(P<0.05)。术后7 d血清cFN、Alb/HbA1c、IFN-γ水平预测预后的效能高于术后3 d,其中cFN预测预后的AUC最大,为0.857。【结论】 创伤性脑出血SLTC术患者术后早期cFN、IFN-γ呈升高趋势,Alb/HbA1c呈降低趋势,检测术后7 d各指标水平能为临床预测预后提供重要的参考信息。

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	王晓丽
	王艳艳
	于艳红

关键词 ：脑出血,创伤性 /外科学, 减压术,外科, 连接蛋白类, 干扰素γ, 神经康复

Abstract：【Objective】 To investigate the perioperative dynamics of cellular fibronectin (cFN), albumin (Alb)/glycated hemoglobin (HbA1c) and interferon-γ (IFN-γ) in patients with traumatic cerebral hemorrhage during standard large trauma craniotomy (SLTC) and analyze its relationship with neurological function. 【Methods】 A total of 219 patients with traumatic intracerebral hemorrhage who were scheduled to undergo SLTC surgery between May 2017 and February 2020 in our hospital were selected. According to the prognosis 30 days after operation, they were divided into a good prognosis group (107 cases) and a poor prognosis group (112 cases). The cFN, Alb/HbA1c, IFN-γ, the National Institutes of Health Stroke Scale (NIHSS), and Glasgow Coma Scale (GCS) scores were compared between the two groups. Pearson was used to analyze the correlation of cFN, Alb/HbA1c and IFN-γ with GCS score and NIHSS score. Receiver operating characteristic curve (ROC) and area under ROC (AUC) were used to analyze the efficacy of cFN, Alb/HbA1c, and IFN-γ in predicting prognosis. 【Results】 Compared to those before operation, serum levels of cFN, Alb/HbA1c, IFN-γ, GCS score, and NIHSS score between the two groups of patients at different times were differences; and the differences were statistically significant (P<0.05). If serum levels of cFN, Alb/HbA1c and IFN-γ, GCS score and NIHSS score at 3 and 7 days after operation were compared, there were statistically significant differences between the two groups (P<0.05). The cFN, Alb/HbA1c and IFN-γ at 3 and 7 days after operation were significantly correlated with the GCS score and NIHSS score at 3 and 7 days after operation (P<0.05). The serum cFN, Alb/HbA1c, and IFN-γ levels at 7 d after surgery were more effective in predicting prognosis than at 3 d after surgery. Among them, cFN had the largest AUC for predicting prognosis, which is 0.857.【Conclusion】 In SLTC patients with traumatic cerebral hemorrhage, cFN and IFN-γ tend to increase in the early postoperative period, while Alb/HbA1c tends to decrease. Detecting the level of each index on 7 days after operation can provide important reference information for clinical prediction of prognosis.

Key words： Brain Hemorrhage,Traumatic/SU Decompression, Surgical Connexins Interferon-gamma Neurological Rehabilitation

收稿日期: 2020-11-10

中图分类号:

R743.34

引用本文:

王晓丽, 王艳艳, 于艳红. cFN、Alb/HbA1c、IFN-γ在创伤性脑出血SLTC术患者围术期动态变化及与神经功能的相关性研究[J]. 医学临床研究, 2021, 38(4): 522-525.
WANG Xiao-li, WANG Yan-yan, YU Yan-hong. Perioperative Dynamics of cFN, Alb/HbA1c and IFN-γ in Patients with Traumatic Cerebral Hemorrhage undergoing Standard Large Trauma Craniotomy and Relationship with Neurological Function. JOURNAL OF CLINICAL RESEARCH, 2021, 38(4): 522-525.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.04.012 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I4/522