ANGPTL2 NDRG3及CCL5生物标志物组合对重型高血压性脑出血预后的预测效能OA
Predictive efficacy of ANGPTL2,NDRG3,and CCL5 as a biomarker combination for the prognosis of severe hypertensive intracerebral hemorrhage
目的 探究血管生成素样蛋白2(ANGPTL2)、N-myc下游调节基因3(NDRG3)及CC类趋化因子配体 5(CCL5)生物标志物组合对重型高血压性脑出血(HICH)预后的预测效能.方法 选取2023-01-2025-02首都医科大学附属北京友谊医院收治的192例重型HICH患者,另选取同期轻、中型HICH患者各96例,根据术后3个月预后将重型HICH患者分为不良组、良好组.比较不同病情和预后患者血清ANGPTL2、NDRG3、CCL5水平,Logistic回归分析重型HICH患者预后的影响因素,采用平滑曲线拟合分析血清ANGPTL2、NDRG3、CCL5水平与预后不良的关系,受试者工作特征(ROC)曲线评估其预测价值.结果 重型HICH患者血清ANGPTL2、NDRG3、CCL5水平>中型患者>轻型患者(P<0.05).预后不良组血清ANGPTL2、NDRG3、CCL5水平高于良好组(P<0.05).神经元特异性烯醇化酶(NSE)、ANGPTL2、NDRG3、CCL5均是重型HICH患者预后不良的危险因素,入院格拉斯哥昏迷量表(GCS)评分是其保护因素(P<0.05).血清ANGPTL2、NDRG3、CCL5水平与重型HICH患者预后不良呈正向线性关系(P<0.05),三者联合的生物标志物组合曲线下面积(AUC)为0.938,显著高于单一及两两联合预测(P<0.05).外部验证显示,生物标志物组合预测重型HICH患者预后不良的AUC为0.939,敏感度92.31%,特异度84.21%.结论 血清 ANGPTL2、NDRG3、CCL5 与 HICH病情程度、预后密切相关,三者生物标志物组合对重型HICH患者预后不良具有较高的预测价值.
Objective To investigate the predictive efficacy of angiopoietin-like protein 2(ANGPTL2),N-myc downstream regulatory gene 3(NDRG3)and CC chemokine ligand 5(CCL5)as a biomarker combination for the prognosis of severe hypertensive intracerebral hemorrhage(HICH).Methods A total of 192 patients with severe HICH in Beijing Friendship Hospital of Capital Medical University from January 2023 to February 2025 were selected,96 patients with mild and 96 patients with moderate HICH were selected in the same period.According to the prognosis of 3 months after operation,patients with severe HICH were divided into poor prognosis group and good prognosis group.The levels of serum ANGPTL2,NDRG3 and CCL5 in patients with different conditions and prognosis were compared.Logistic regression was used to analyze the influencing factors for the prognosis in patients with severe HICH.Smooth curve fitting was used to analyze the relationship between serum ANGPTL2,NDRG3 and CCL5 levels and poor prognosis.Receiver operating characteristic(ROC)curve was used to evaluate its predictive value.Results The serum levels of ANGPTL2,NDRG3 and CCL5 in patients with severe HICH>moderate HICH>mild HICH(P<0.05).The levels of serum ANGPTL2,NDRG3 and CCL5 in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Neuron-specific enolase(NSE),ANGPTL2,NDRG3 and CCL5 were all risk factors for poor prognosis in patients with severe HICH,and admission Glasgow coma scale(GCS)score was a protective factor(P<0.05).The levels of serum ANGPTL2,NDRG3 and CCL5 showed a positive linear relationship with the poor prognosis of patients with severe HICH(P<0.05).The area under curve(AUC)of the combination of three biomarkers was 0.938,which was significantly higher than that of single and combined prediction(P<0.05).External validation showed that the AUC of biomarker combination for predicting poor prognosis in patients with severe HICH was 0.939,the sensitivity was 92.31%,and the specificity was 84.21%.Conclusion Serum ANGPTL2,NDRG3 and CCL5 are closely related to the severity and prognosis of HICH,and the combination of three biomarkers has a high predictive value for the poor prognosis of patients with severe HICH.
唐亚男;陈倩;魏建强
首都医科大学附属北京友谊医院,北京 100000首都医科大学附属北京友谊医院,北京 100000河北医科大学附属唐山市工人医院,河北 唐山 063000
医药卫生
高血压性脑出血血管生成素样蛋白2N-myc下游调节基因3CC类趋化因子配体5预后
Hypertensive intracerebral hemorrhageAngiopoietin-like protein 2N-myc downstream regulatory gene 3CC chemokine ligand 5Prognosis
《中国实用神经疾病杂志》 2026 (6)
667-673,7
河北省医学科学研究重点课题计划项目(编号:20231776)
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