知识与财富的链接
目的 探讨急性自发性脑出血（ICH）患者血清HA水平的表达情况及临床意义。 方法 选取2016年4月～2017年8月我院收治的120例ICH患者为研究对象,并选取同期体检的102例健康者为对照组。采用改良Rankin 量表对ICH患者出院后3个月情况进行评分,根据评分分为预后良好者（≤2分）和预后不良者(＞2分),观察并分析患者透明质酸（HA）水平表达及临床意义。结果 预后良好者的年龄、血肿体积均明显低于预后不良者,差异有统计学意义（均P＜0.05）。入院时,ICH组患者HA水平明显高于对照组,差异有统计学意义（P＜0.05）。入院时,预后良好者美国国立卫生研究院卒中量表（NIHSS）评分及HA水平均明显低于预后不良者,且NIHSS评分与HA表达水平呈正相关（r=0.573,均P＜0.05）;治疗3个月后,mRS评分与HA表达水平亦呈正相关（r=0.757,P＜0.05）。单因素表示,预后良好者的年龄、血肿体积、HA水平、NIHSS评分及mRS评分与预后不良者比较,差异有统计学意义（P＜0.05）。Logistic多因素回归分析表示,年龄、血肿体积、HA水平、NIHSS评分及mRS评分与ICH患者预后不良相关。结论 ICH患者血清HA水平表达异常升高,病情严重,预后较差。因此,入院时血清HA水平的高表达可作为预后不良的预测因素。
Objective To investigate the expression and clinical significance of serum HA level in patients with acutespontaneous intracerebral hemorrhage (ICH). Methods 120 patients with acute spontaneous intracerebral hemorrhage admitted in our hospital between April 2016 and August 2017 were enrolled as subjects. At the same time, 102 healthy subjects were selected as the control group. The patients were graded 3 months after discharge using the modified Rankin scale. The patients were divided into favorable prognosis group (FPG) and poor prognosis group (PPG), according to the score. The HA level expression and clinical significance of the two groups were observed and analyzed. Results At admission,the HA level in the ICH group was significantly higher than that in the control group (P＜0.05). The age and hematoma volume of FPG were significantly lower than those of PPG (P＜0.05). After admission, the NIHSS（National Institutes of Health Stroke Scale） scores in FPG were significantly lower than those in PPG (P＜0.05). The NIHSS score was positively correlated with HA expression at admission (r=0.573, P＜0.001). After 3 months of treatment, the mRS score of FPG was significantly lower than that of PPG (P＜0.05); the mRS score was positively correlated with HA expression (r=0.757, P＜0.001). The NIHSS score and HA level of FPG were significantly lower than those of PPG (P＜0.05). Univariate analysis showed that the age, hematoma volume, HA level, NIHSS score, and mRS score of the favorable prognosis group were significantly different from those of the poor prognosis group (P＜0.05). Logistic regression analysis showed that age, hematoma volume, HA level, NIHSS score and mRS score wereassociated with poor prognosis in patients with ICH. Conclusion The expression of serum HA level in patients with acutespontaneous ICH is abnormally increased with serious condition and poor prognosis. Therefore, high expression of serum HA at admission can be used as a predictor of poor prognosis.
