[1]裴双,孙军,汪宁,等.循环内CD40/CD40L信号通路表达水平变化与蛛网膜下腔出血患者介入治疗后疗效的关系[J].卒中与神经疾病杂志,2025,32(01):83-88.[doi:10.3969/j.issn.1007-0478.2025.01.014]
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循环内CD40/CD40L信号通路表达水平变化与蛛网膜下腔出血患者介入治疗后疗效的关系()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第32卷
期数:
2025年01期
页码:
83-88
栏目:
论著
出版日期:
2025-02-20

文章信息/Info

文章编号:
1007-0478(2025)01-0083-06
作者:
裴双; 孙军; 汪宁; 邱星辰; 张在行; 李祥欣; 郭彦俊; 温昌明
473000 河南省南阳市中心医院神经内科介入病区[裴双 孙军 汪宁 邱星辰 张在行 李祥欣 郭彦俊 温昌明(通信作者)]
关键词:
动脉瘤性蛛网膜下腔出血 可溶性CD40配体 预后 炎症
分类号:
R743.35
DOI:
10.3969/j.issn.1007-0478.2025.01.014
文献标志码:
A
摘要:
目的 探讨循环内CD40/CD40L信号通路表达水平变化与动脉瘤性蛛网膜下腔出血(Aneurysmal subarachnoid hemorrhage,aSAH)患者介入治疗后疗效的关系。方法 研究人群包括2021年2月-2023年6月入住本院所有18岁以上诊断为aSAH并接受血管内介入治疗的124例患者; 在aSAH治疗3个月后使用Rankin评分(Modified Rankin scale,mRS)量表评分评估短期结局; 将患者分为2组:良好结局组(mRS评分≤3分,n=65)和不良结局组(mRS得分≥4分,n=59); 使用酶联免疫吸附测定法(Enzyme linked immunosorbent assay,ELISA)评估血浆中可溶性CD40配体(Soluble CD 40 ligand,sCD40L)、白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)水平。结果 与良好结局组比较,不良结局组年龄、高血压病、再出血、急性脑积水、肺炎的比例、世界神经外科医生联合会(World federation of neurosurgical societies,WFNS)评分、享持-赫斯(Hunt-Hess)评分、费希尔(Fisher)评分、IL-6,TNF-α,sCD40L水平均显著增高(P<0.05)。sCD40L水平与WFNS评分、Hunt-Hess评分、IL-6,TNF-α水平呈显著正相关(ρ=0.371、0.309、0.294、0.182,P均<0.05); IL-6水平与WFNS评分、Hunt-Hess评分、TNF-α水平呈显著正相关(ρ=0.180、0.238、0.693,P均<0.05)。年龄(OR=1.078,95%CI=1.017～1.142)、高血压病(OR=4.650,95%CI=1.167～18.527)、Hunt-Hess评分(OR=3.463,95%CI=1.997～6.006)和sCD40L水平(OR=1.033,95%CI=1.017～1.048)是aSAH患者不良预后的独立影响因素(P<0.05)。年龄、高血压病、Hunt-Hess评分、sCD40L水平组合预测aSAH患者不良预后的能力最大,曲线下面积(Area under the curve,AUC)为0.949,敏感度为91.5%,特异度为87.7%。结论 血浆sCD40L水平与aSAH患者的病情严重程度和不良预后相关,并且sCD40L水平、年龄、高血压病等指标的加入增强了Hunt-Hess评分对aSAH患者不良预后的预测性能。

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备注/Memo

备注/Memo:
基金项目:河南省二○二三年科技发展计划项目(232102310198)
更新日期/Last Update: 2025-02-20