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

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

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

基金资助

安徽高校省级自然科学研究重大资助项目(KJ2020ZD24)