脑出血患者循环血中HBP、ALT、AST、WBC、NEU、PLT表达与感染及预后的相关性

杨舒馨影, 李涛

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重庆医科大学学报 ›› 2024, Vol. 49 ›› Issue (10) : 1119-1124. DOI: 10.13406/j.cnki.cyxb.003597
临床研究

脑出血患者循环血中HBP、ALT、AST、WBC、NEU、PLT表达与感染及预后的相关性

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Association of the expression of heparin-binding protein,alanine aminotransferase,and aspartate aminotransferase,white blood cell count,neutrophil ratio,and platelet count in circulating blood with infection and prognosis in patients with cerebral hemorrhage

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摘要

目的 讨论脑出血患者循环血中肝素结合蛋白(heparin-binding protein,HBP)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、白细胞(white blood cell,WBC)、中性粒细胞比率(neutrophil,NEU)、血小板(platelet,PLT)表达水平,分析其与患者感染及预后的关系。 方法 选取脑出血患者164例,入院和出院时分别检测循环血中HBP、ALT、AST、WBC、NEU和PLT水平,分组分析以上指标与感染和预后的相关性。 结果 感染组HBP、WBC、NEU、PLT最高值水平均高于非感染组。感染组患者预后比较ALT和WBC最高值、非感染组患者预后比较NEU最高值,差异有统计学意义(P<0.05)。AST最高值是否异常在不同预后情况中比例相反。ROC曲线分析显示,HBP、ALT、AST、WBC最高值联合检测对脑出血患者预后不良的曲线下面积为0.781,敏感度和特异度分别为85.7%和62.7%。 结论 脑出血患者循环血中HBP、WBC、NEU及PLT在检测中最高值异常高表达提示感染风险,当HBP、ALT、AST、WBC水平联合检测对脑出血患者预后不良具有较好的预测效能。

Abstract

Objective To investigate the expression levels of heparin-binding protein(HBP),alanine aminotransferase(ALT),and aspartate aminotransferase(AST),white blood cell count(WBC),neutrophil ratio(NEU),and platelet count(PLT) in circulating blood of patients with cerebral hemorrhage,as well as their association with infection and prognosis. Methods A total of 164 patients with cerebral hemorrhage were enrolled,and the levels of HBP,ALT,AST,WBC,NEU,and PLT in circulating blood were measured on admission and at discharge to investigate their association with infection and prognosis. Results The highest values of HBP,WBC,NEU,and PLT in the infection group were higher than those in the non-infection group. In the infection group,there were significant differences in the highest values of ALT and WBC between the patients with good prognosis and those with poor prognosis,and in the non-infection group,there was a significant difference in the highest value of NEU between the patients with good prognosis and those with poor prognosis(P<0.05). Whether the highest AST value is abnormal or not is proportionally opposite in different prognostic scenarios. The receiver operating characteristic(ROC) curve analysis showed that combined measurement of the highest values of HBP,ALT,AST,and WBC had an area under the ROC curve of 0.781 in predicting the poor prognosis of patients with cerebral hemorrhage,with a sensitivity of 85.7% and a specificity of 62.7%. Conclusion The abnormal high expression of the highest values of HBP,WBC,NEU,and PLT in circulating blood of patients with cerebral hemorrhage indicates the risk of infection,and combined measurement of HBP,ALT,AST,and WBC has a good performance in predicting the poor prognosis of patients with cerebral hemorrhage.

关键词

脑出血 / 预后 / 感染 / 肝素结合蛋白 / 丙氨酸氨基转移酶 / 天冬氨酸氨基转移酶 / 白细胞 / 中性粒细胞比率 / 血小板

Key words

cerebral hemorrhage / prognosis / infection / heparin-binding protein / alanine aminotransferase / aspartate aminotransferase / white blood cell count / neutrophil ratio / platelet count

中图分类号

R734.34

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导出引用
杨舒馨影 , 李涛. 脑出血患者循环血中HBP、ALT、AST、WBC、NEU、PLT表达与感染及预后的相关性. 重庆医科大学学报. 2024, 49(10): 1119-1124 https://doi.org/10.13406/j.cnki.cyxb.003597
Yang Shuxinying, Li Tao. Association of the expression of heparin-binding protein,alanine aminotransferase,and aspartate aminotransferase,white blood cell count,neutrophil ratio,and platelet count in circulating blood with infection and prognosis in patients with cerebral hemorrhage[J]. Journal of Chongqing Medical University. 2024, 49(10): 1119-1124 https://doi.org/10.13406/j.cnki.cyxb.003597

参考文献

1
Gedansky A Jarvis P Yu DH,et al.Intracerebral hemorrhage in a young urban population:etiologies and outcomes in patients 50 and younger[J].J Stroke Cerebrovasc Dis201928(10):104295.
2
林 锋,宋 鹏,谭博,等. 脑出血患者血清B淋巴细胞瘤-2水平与功能预后的相关性[J]. 心脑血管病防治202222(4):69-72,76.
Lin F Song P Tan B,et al. Correlation between serum B-lymphoma-2 level and functional prognosis in patients with cerebral hemorrhage[J]. Cardio Cerebrovasc Dis Prev Treat202222(4):69-72,76.
3
骆明涛,伍 聪,陶传元,等. 《高血压性脑出血中国多学科诊治指南》急救诊治解读[J]. 中国急救医学202141(3):185-190.
Luo MT Wu C Tao CY,et al. Interpretation of emergency treatment of Chinese multidisciplinary guideline for management of hypertensive intracerebral hemorrhage[J]. Chin J Crit Care Med202141(3):185-190.
4
秦小平. 实用医院感染管理指南[M]. 北京:人民军医出版社,2014:133-145.
Qin XP. Practical guide to hospital infection management[M]. Beijing:People’s Military Medical Press,2014:133-145.
5
中国研究型医院学会神经再生与修复专委会脑血管病学组. 高血压性脑出血的诊断和治疗:专家观点与规范推荐[J]. 中国血液流变学杂志201929(2):127-129.
Diagnosis and treatment of hypertensive cerebral hemorrhage:expert opinion and standard recommendation[J]. Chin J Hemorheol201929(2):127-129.
6
肖金平,程 娜,向天新,等. 多重耐药鲍曼不动杆菌颅内感染耐药性危险因素研究[J]. 安徽医科大学学报202055(2):308-311.
Xiao JP Cheng N Xiang TX,et al. Risk factors of drug resistance in intracranial infection of multi-drug resistant Acinetobacter baumanni [J]. Acta Univ Med Anhui202055(2):308-311.
7
Ding W Gu ZW Song DG,et al. Development and validation of the hypertensive intracerebral hemorrhage prognosis models[J]. Medicine201897(39):e12446.
8
金子凡,冯 娟. 中性粒细胞与淋巴细胞比值对原发性急性脑出血患者短期预后的预测作用[J]. 中国脑血管病杂志201815(5):236-240,253.
Jin ZF Feng J. Predictive effect of neutrophil-to-lymphocyte ratio on short-term prognosis in primary patients with acute intracerebral hemorrhage[J]. Chin J Cerebrovasc Dis201815(5):236-240,253.
9
中华神经科学会,中华神经外科学会. 各类脑血管疾病诊断要点[J]. 中华神经科杂志199629(6):379-380.
Chinese Society of Neuroscience,Chinese Society of Neurosurgery. Diagnostic criteria for various cerebrovascular diseases[J]. Chinese Journal of Neurology199629 (6):379-380.
10
方黎晓,胡少玄,孙 龙,等. 脑外伤患者术后颅内感染病原菌分析与对一氧化氮及降钙素原水平影响研究[J]. 中华医院感染学杂志201626(5):1095-1097.
Fang LX Hu SX Sun L,et al. Pathogen distribution and effect on serum NO and PCT concentration in cerebral trauma patients with postoperative intracranial infection[J]. Chin J Nosocomiology201626(5):1095-1097.
11
邹 标. 高血压脑出血患者发生肺部感染的病原菌分布与耐药情况分析[J]. 抗感染药学202219(10):1430-1433.
Zou B. Distribution and drug resistance of pathogens causing pulmonary infection in patients with hypertensive cerebral hemorrhage[J]. Anti Infect Pharm202219(10):1430-1433.
12
李景余,臧丽丽,吕慧静,等. 脑出血术后病人肺部感染危险因素分析及风险预测模型构建[J]. 护理研究202236(17):3055-3060.
Li JY Zang LL Lyu HJ,et al. Risk factor analysis and establishment of predictive model for pulmonary infection in postoperative patients with intracerebral hemorrhage[J]. Chin Nurs Res202236(17):3055-3060.
13
李 辉,李 丽,杨松,等. 白细胞升高:容易忽略的几种病毒感染[J]. 中华临床医师杂志(电子版),202014(10):830-834.
Li H Li L Yang S,et al. Elevated white blood cell count:a possible cause of missed diagnosis of several kinds of virus infection[J]. Chin J Clin Electron Ed202014(10):830-834.
14
马丽萍,罗先明. 血小板与细菌感染[J]. 血栓与止血学201218(6):245-246.
Ma LP Luo XM. Platelets and bacterial infection[J]. Chin J Thromb Hemostasis201218(6):245-246.
15
何晓清,刘 娟,杨录波,等. 血清肝素结合蛋白对重症监护室危重患者感染的诊断价值[J]. 检验医学与临床201613(11):1568-1570.
He XQ Liu J Yang LB,et al. Diagnostic value of serum heparin binding protein for infection in critically ill patients in intensive care unit[J]. Lab Med Clin201613(11):1568-1570.
16
马承福. 肝素结合蛋白和降钙素原及C反应蛋白在脓毒症早期诊断中的价值比较[J]. 临床医药文献电子杂志20174(94):18446.
Ma CF. Comparison of heparin binding protein,procalcitonin and C-reactive protein in early diagnosis of sepsis[J]. J Clin Med Lit20174(94):18446.
17
谢海花,卢 明,屈 辉,等. 重型颅脑损伤患者伤后3个月肢体运动功能及肌力的影响因素分析[J]. 保健医学研究与实践202320(4):77-81.
Xie HH Lu M Qu H,et al. Influencing factors of limb motor function and muscle strength in patients with severe craniocerebral injury 3 months after injury[J]. Health Med Res Pract202320(4):77-81.

基金

安徽高校省级自然科学研究重大资助项目(KJ2020ZD24)

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