中老年动脉瘤性蛛网膜下腔出血患者血清磺脲类受体1表达及其与预后的关系

顾天一; 杨其国; 金波

doi:10.16766/j.cnki.issn.1674-4152.001867

中老年动脉瘤性蛛网膜下腔出血患者血清磺脲类受体1表达及其与预后的关系

doi: 10.16766/j.cnki.issn.1674-4152.001867

宁波市第六医院神经外科，浙江宁波 315000

基金项目:

浙江省医药卫生科技计划项目 2017KY148

详细信息

通讯作者:
顾天一, E-mail: tianyigu473@163.com

中图分类号: R743.35 R446
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- 被引次数: 0
出版历程
- 收稿日期: 2020-01-13
- 网络出版日期: 2022-02-16

Expression of serum SUR1 in middle-aged and elderly patients with aneurysmal subarachnoid hemorrhage and its relationship with prognosis

Department of Neurosurgery, Ningbo Sixth Hospital, Ningbo, Zhejiang 315000, China

摘要

摘要: 目的探讨中老年动脉瘤性蛛网膜下腔出血(aSAH)患者血清磺脲类受体1(SUR1)表达及其与预后的相关性。方法选取宁波市第六医院2015年7月—2019年5月收治的91例aSAH患者为观察对象，采用荧光实时定量聚合酶链反应(qRT-PCR)检测术前血清SUR1表达，将所有患者依据术前血清SUR1表达中位数分为SUR1低表达组(46例)、SUR1高表达组(45例)；术前采用美国国立卫生研究院卒中量表(NIHSS)评分评估aSAH患者神经缺损程度，术后6个月采用格拉斯哥预后评分(GOS)评估预后，将患者分为预后良好组(77例)、预后不良组(14例)。比较预后良好组与预后不良组术前血清SUR1表达；采用Spearman分析患者血清SUR1表达与NIHSS评分相关性；采用COX模型分析aSAH患者预后影响因素。结果预后良好组高血压史患者比例、糖尿病史患者比例、术前NIHSS评分、手术时机均低于预后不良组(均P < 0.05)；与预后良好组相比，预后不良组aSAH患者血清SUR1表达较高(P < 0.05)；Spearman相关分析显示，aSAH患者血清SUR1表达与NIHSS评分呈正相关(P < 0.05)；COX回归模型分析结果显示，年龄 > 60岁、有高血压史、有糖尿病史、NIHSS评分≥15分、手术时机3~7 d、SUR1高表达均是aSAH患者预后的独立危险因素(均P < 0.05)。结论 SUR1可能参与中老年aSAH的发生及病情演变，有可能成为评估aSAH病情的血清学指标及治疗靶点。
- 中老年 /
- 动脉瘤性蛛网膜下腔出血 /
- 磺脲类受体1 /
- 预后
Abstract: Objective To investigate the expression and correlation of serum sulfonylurea receptor 1 (SUR1) in middle-aged and elderly patients with aneurysmal subarachnoid haemorrhage (aSAH). Methods Ninety-one patients suffering from aSAH admitted to Ningbo Sixth Hospital from July 2015 to May 2019 were selected as the observation objects. The expression of SUR1 in serum before operation was detected via fluorescence real-time quantitative polymerase chain reaction. According to the median expression of Sulfonylurea receptor 1(SUR1) in serum before operation, the patients were divided into low SUR1 expression group (n=46) and high SUR1 expression group (n=45). Before operation, the degree of nerve defect in the patients with aSAH was evaluated using the national institutes of health stroke scale (NIHSS) score. At 6 months after operation, prognosis was assessed using the Glasgow Outcome Scale, and the patients were divided into good prognosis group (n=77) and poor prognosis group (n=14). The expression of SUR1 before operation was compared between the two groups. The correlation between SUR1 expression and NIHSS score was evaluated via Spearman correlation analysis. The prognostic factors of the patients with aSAH were analysed via Cox model. Results The proportion of patients with hypertension history, with diabetes history, preoperative NIHSS score and operative timing in the good prognosis group were lower than those in the poor prognosis group (all P < 0.05). The expression of serum SUR1 in patients with aSAH in the poor prognosis group was higher than that in the good prognosis group (P < 0.05). Spearman correlation analysis revealed a positive correlation between serum SUR1 expression and NIHSS score in the patients with aSAH (P < 0.05). The Results of Cox regression model showed that age of >60 years, history of hypertension, history of diabetes, NIHSS score ≥15, 3-7 d of operation timing and SUR1 overexpression were all independent risk factors for the prognosis of patients with aSAH (all P < 0.05). Conclusion SUR1 may be involved in the development and progression of aSAH in the middle-aged and the elderly, and may become a serological index for the assessment of aSAH and treatment target.
- Middle-aged people and the elderly /
- Aneurysmal subarachnoid haemorrhage /
- Sulfonylurea receptor 1 /
- Prognosis

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图 1 aSAH患者血清SUR1表达与NIHSS评分的散点图

下载: 全尺寸图片幻灯片

表 1 2组aSAH患者一般资料比较[例(%)]

组别	例数	性别(男/女, 例)	年龄(x±s, 岁)	高血压史	糖尿病史	饮酒史	高脂血症史	术前NIHSS评分(x±s, 分)	手术时机(x±s, d)
预后良好组	77	50/27	63.29±7.25	19(24.68)	6(7.79)	10(12.99)	12(15.58)	13.62±3.59	3.53±0.85
预后不良组	14	8/6	64.03±6.61	8(57.14)	5(35.71)	3(21.43)	2(14.29)	17.18±4.33	5.29±1.36
统计量		0.311^a	0.356^b	5.984^a	8.691^a	0.172^a	0.078^a	3.305^b	6.431^b
P值		0.577	0.723	0.014	0.003	0.678	0.780	0.001	< 0.001
注：^a为χ²值，^b为t值。

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表 2 aSAH患者预后危险因素的单因素分析

项目	B	SE	Wald χ²	P值	OR值	95% CI
年龄	0.891	0.289	9.500	0.002	2.437	1.651~3.598
高血压史	0.826	0.253	10.666	0.001	2.284	1.391~3.749
糖尿病史	0.787	0.223	12.458	< 0.001	2.197	1.133~4.262
NIHSS评分	0.979	0.271	13.063	< 0.001	2.663	1.582~4.483
手术时机	0.623	0.212	8.643	0.003	1.865	1.568~2.219
SUR1表达	0.886	0.308	8.272	0.004	2.425	1.603~3.668

下载: 导出CSV

表 3 aSAH患者预后危险因素的多因素分析

项目	B	SE	Wald χ²	P值	OR值	95% CI
年龄	0.708	0.221	10.250	0.001	2.029	1.427~2.885
高血压史	0.763	0.242	9.932	0.002	2.144	1.339~3.434
糖尿病史	0.703	0.201	12.236	< 0.001	2.020	1.061~3.844
NIHSS评分	0.750	0.247	9.220	0.002	2.117	1.293~3.466
手术时机	0.486	0.155	9.811	0.002	1.625	1.262~2.093
SUR1表达	0.798	0.168	22.535	< 0.001	2.220	1.597~3.086

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