| 周坦,宋会双,张换立,等.血清 PTX3、Nogo-A对动脉瘤蛛网膜下腔出血病人介入治疗预后的预测价值[J].安徽医药,2025,29(4):683-687. |
| 血清 PTX3、Nogo-A对动脉瘤蛛网膜下腔出血病人介入治疗预后的预测价值 |
| Predictive value of serum PTX3 and Nogo-A for the prognosis of interventional therapy for patients with aneurysm subarachnoid hemorrhage |
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| DOI：10.3969/j.issn.1009-6469.2025.04.009 |
| 中文关键词: 蛛网膜下腔出血 颅内动脉瘤 正五聚蛋白 3 轴突生长抑制因子 A 介入治疗 预后价值 |
| 英文关键词: Subarachnoid hemorrhage Intracranial aneurysm Pentraxin 3 Axon growth inhibitory factor A Interventional treatment Prognostic value |
| 基金项目:廊坊市科技支撑项目( 2019013015) |
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| 中文摘要: |
| 目的通过检测血清正五聚蛋白 3(PTX3)和轴突生长抑制因子 A(Nogo-A)的表达水平，来探讨 PTX3、Nogo-A对动脉瘤蛛网膜下腔出血( aSAH)病人介入治疗预后的预测价值。方法收集 2020年 1月至 2021年 12月在河北中石油中心医院接受血管内介入治疗的 aSAH病人 108例作为研究对象，根据随访结果，依据格拉斯哥预后评分( GOS)将其分为预后良好组( 72例)和预后不良组( 36例)。通过酶联免疫吸附分析( ELISA)检测各组血清 PTX3、Nogo-A的表达水平；使用 Spearman法分析血清 PTX3、Nogo-A水平与 GOS评分的相关性；采用 logistic多因素回归分析与 aSAH病人介入治疗后预后状况有关的影响因素；绘制受试者操作特征曲线( ROC曲线)观察血清 PTX3、Nogo-A水平对 aSAH病人介入治疗预后的预测价值。结果预后不良组血清 PTX3(2.54±0.76)μg/L、Nogo-A(170.15±19.18)μg/L的表达水平均高于预后良好组血清 PTX3(1.49±0.38)μg/L、Nogo-A(135.64±16.12)μg/L水平( P<0.05)。 Spearman相关性分析结果显示， aSAH病人血清中 PTX3、Nogo-A表达水平与 GOS评分呈负相关( r=.0.62、.0.62，均 P<0.05)。 logistic回归分析结果显示， Hunt-Hess分级、改良 Fisher分级、血清 PTX3、Nogo-A均是 aSAH病人介入治疗预后不良的独立危险因素( P<0.05)。 ROC曲线结果发现，血清 PTX3、Nogo-A预测 aSAH病人介入治疗预后的最佳截断值分别为 1.90 μg/L、147.83 μg/L，曲线下面积( AUC)分别为 0.86、0.90，当二者联合时其 AUC为 0.95，高于两者单独检测(P<0.05)。结论 aSAH病人血清中 PTX3、Nogo-A表达水平异常升高，二者联合检测对 aSAH病人预后不良具有较高的预测价值。 |
| 英文摘要: |
| Objective To detect the expression levels of serum pentraxin 3 (PTX3) and axon growth inhibitory factor A (Nogo-A), and to explore the predictive value of PTX3 and Nogo-A for the prognosis of patients with aneurysm subarachnoid hemorrhage (aSAH) after interventional therapy.Methods From January 2020 to December 2021, 108 aSAH patients who received endovascular interventionaltherapy in Hebei Petro China Central Hospital were collected as research subjects. The patients were followed up for half a year aftertreatment. According to the Glasgow Outcome Scale (GOS), 108 patients were grouped into a good prognosis group (72 cases) and a poorprognosis group (36 cases). Enzyme-linked immunosorbent assay (ELISA) was performed to detect the expression levels of serum PTX3 and Nogo-A in each group; Spearman correlation analysis was performed to analyze the correlation between serum PTX3 and Nogo-A levels and GOS score; logistic regression was performed to analyze the factors influencing the interventional therapy prognosis in aSAHpatients; ROC curves were drawn to observe the predictive value of serum PTX3 and Nogo-A levels for the prognosis of aSAH patients undergoing interventional therapy.Results The expression levels of serum PTX3 (2.54±0.76) μg/L and Nogo-A (170.15±19.18) μg/Lin the poor prognosis group were higher than those in the good prognosis group PTX3 (1.49±0.38) μg/L and Nogo-A (135.64±16.12) μg/ L(P<0.05). The results of Spearman correlation analysis showed that the expression levels of PTX3 and Nogo-A in the serum of aSAH patients were negatively correlated with the GOS score (r=.0.62, .0.62, P<0.05). Logistic regression analysis showed that Hunt-Hess sgrade, modified Fisher grade, serum PTX3 and Nogo-A were independent risk factors of poor prognosis of aSAH patients after interven. tional therapy (P<0.05). The results of the ROC curve showed that the best cut-off values of serum PTX3 and Nogo-A for predicting theprognosis of aSAH patients after interventional therapy were 1.90 μg/L and 147.83 μg/L, respectively, and the areas under the curve(AUC) were 0.86 and 0.90, respectively. When the two were combined, the AUC was 0.95, which was higher than that detected by thetwo alone (P<0.05).Conclusion The expression levels of PTX3 and Nogo-A in the serum of patients with aSAH are abnormally in. creased, and the combined detection of the two has a high predictive value for poor prognosis of patients with aSAH. |
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