Relationship of HIF-1α, NLRP3 and Adropin with Neurological Deficit in Patients with Cerebral Infarction after Hematoma Removal from Hypertensive Cerebral Hemorrhage
摘要【目的】探讨缺氧诱导因子-1α(HIF-1α)、核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、Adropin与高血压脑出血(HICH)血肿清除术后并发脑梗死患者神经缺损的相关性。【方法】回顾性分析2018年6月至2021年3月本院收治的151例HICH血肿清除术后并发脑梗死患者的临床资料,根据患者30 d预后情况将其分为不良组(n=34)和良好组(n=117)。比较两组基线资料、美国国立卫生研究院卒中量表(NIHSS)评分及术前、术后3 d 血清HIF-1α、NLRP3、Adropin水平,应用Pearson分析HIF-1α、NLRP3、Adropin与NIHSS评分关系,采用受试者工作特征曲线(ROC曲线)分析HIF-1α、NLRP3、Adropin对不良预后预测价值。【结果】不良组血肿量高于良好组,入院时格拉斯哥昏迷评分(GCS)低于良好组(P<0.05)。与术前比较,两组术后3 d血清HIF-1α、NLRP3水平均升高,Adropin、NIHSS评分均降低,不良组术后3 d血清HIF-1α、NLRP3水平及NIHSS评分高于良好组,Adropin水平低于良好组(P<0.05)。Pearson相关性分析显示,HIF-1α、NLRP3与NIHSS评分呈正相关(r分别为0.550、0.659,均P<0.05),Adropin与NIHSS评分呈负相关(r=－0.679,P<0.05)。ROC曲线结果显示,术后3 d HIF-1α、NLRP3联合Adropin预测不良预后的AUC、敏感度、特异度最大。【结论】HIF-1α、NLRP3、Adropin与HICH血肿清除术后并发脑梗死患者神经缺损、预后情况有关,联合检测可作为预测患者预后的有效指标,为临床预防患者病情恶化及治疗提供参考依据。
Abstract：【Objective】 To investigate the relationship of hypoxia-inducible factor-1α (HIF-1α), nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) and Adropin with nerve defects in patients with hypertensive intracerebral hemorrhage (HICH) complicated with brain infarction after hematoma removal. 【Methods】A total of 151 patients with cerebral infarction after HICH hematoma removal in our hospital from June 2018 to March 2021 were selected and divided into the poor prognosis group (n=34) and the good prognosis group (n=117) according to the 30-day prognosis. The baseline data, the National Institutes of Health Stroke Scale (NIHSS) and HIF-1α, NLRP3, Adropin (before and 3 days after surgery) were compared between the two groups. Pearson analysis was used to analyze the correlation of HIF-1α, NLRP3 and Adropin with NIHSS scores. Cox regression analysis, receiver operating characteristic curve (ROC) and ROC area (AUC) analysis predicted prognosis value of HIF-1α, NLRP3 and Adropin. 【Results】The volume of hematoma in the poor group was higher than that of the good group, and the GCS score at admission was lower than that of the good group (P<0.05). Compared with preoperative, serum HIF-1α and NLRP3 levels in both groups were increased on 3 days after operation, while Adropin and NIHSS scores were decreased in both groups. The levels of HIF-1α, NLRP3, and NIHSS scores of the poor group were higher than those of the good group at 3 days postoperatively, and Adropin was lower than the good group (P<0.05). HIF-1α and NLRP3 were positively correlated with NIHSS score (r=0.550, 0.659, both P<0.05), and Adropin was negatively correlated with NIHSS score (r=-0.679, P<0.05). The ROC curve results showed that HIF-1α, NLRP3 combined with Adropin had the highest AUC, sensitivity and specificity in predicting poor prognosis 3 days after operation. 【Conclusion】HIF-1α, NLRP3, and Adropin are related to the neurological deficit and prognosis of patients with cerebral infarction after HICH hematoma removal. Combined detection can be used as an effective prognosis prediction plan and provide a reference for clinical prevention of disease deterioration and treatment.
张海平, 李娓, 冯磊, 林涛, 解利平. HIF-1α、NLRP3、Adropin与高血压脑出血血肿清除术后并发脑梗死患者神经缺损的相关性[J]. 医学临床研究, 2022, 39(7): 984-987.
ZHANG Hai-ping, LI Wei, FENG Lei,et al. Relationship of HIF-1α, NLRP3 and Adropin with Neurological Deficit in Patients with Cerebral Infarction after Hematoma Removal from Hypertensive Cerebral Hemorrhage. JOURNAL OF CLINICAL RESEARCH, 2022, 39(7): 984-987.
2022, Vol. 39 
