水通道蛋白4及C3、C4补体与颅脑损伤脑积水脑室-腹腔分流术患者神经功能的相关性及预测预后的效能分析

doi:10.3969/j.issn.1671-7171.2021.02.010

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Abstract 【Objective】 To investigate the correlation between aquaporin 4 (AQP4), C3 and C4 complement levels and neurological function in patients with craniocerebral injury hydrocephalus undergoing ventriculoperitoneal shunt (VPS) and its efficacy of predicting prognosis. 【Methods】 From February 2017 to January 2020, 186 patients with hydrocephalus after craniocerebral injury treated by ventriculoperitoneal shunt were prospectively selected and divided into good prognosis group (n=146) and poor prognosis group (n=40) according to the prognosis of the patients. The levels of AQP4, C3 and C4, NIHSS and GCS were compared between the two groups before operation and 1, 3 and 7 days after operation. Pearson was used to analyze the correlation between serum AQP4, C3, C4 levels and NIHSS, GCS scores. Receiver operating characteristic curve (ROC) was used to analyze the efficacy of single and combined prediction of prognosis.【Results】 At 1 d and 3 d after surgery, the serum AQP4, C3, and C4 levels in both groups were higher than that before surgery, with a decreasing trend at 7 d after surgery in the good prognosis group but not in the poor prognosis group at 7 d after surgery (P<0.05); the levels of serum AQP4, C3, and C4 in the good prognosis group at 1 d, 3 d, and 7 d after surgery were lower than those in the poor prognosis group (P<0.05). At 3 d and 7 d after surgery, NIHSS scores in the good prognosis group showed a decreasing trend and GCS scores showed an increasing trend, and NIHSS scores at 3 D and 7 d after surgery in the good prognosis group were lower than those in the poor prognosis group, and GCS scores were higher than those in the poor prognosis group (P<0.05). Serum AQP4, C3 and C4 levels were significantly correlated with corresponding NIHSS and GCS scores at 1 d, 3 d and 7 d after surgery (P<0.05) , and the strongest correlation was observed for each index at 3 d after surgery. ROC curves showed that the AUC of the combined test for predicting prognostic efficacy was 0.895, 95%CI was (0.832-0.959), which was in turn superior to C3, C4 and AQP4, with a predictive sensitivity and specificity of 87.50% and 80.82%, respectively.【Conclusion】 The serum levels of AQP4, C3 and C4 were significantly increased in patients with ventriculoperitoneal shunt placement for craniocerebral injury hydrocephalus, and they were closely related to neurological function, and the combined detection of changes in their levels could help to improve the prognostic predictive value.

Key words： Craniocerebral Trauma/SU Brain Injuries/CO Hydrocephalus/TH Ventriculoperitoneal Shunt Aquaporin 4

Received: 10 October 2020

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	CHEN Yun-jiang

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CHEN Yun-jiang. Correlation between Aquaporin 4, C3, C4 and Neurological Function in Patients with Craniocerebral Injury Hydrocephalus VPS and its Efficacy in Predicting Prognosis[J]. JOURNAL OF CLINICAL RESEARCH, 2021, 38(2): 195-198.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2021.02.010 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2021/V38/I2/195

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