脑出血患者血清沉默信息调节因子1表达水平与疾病严重程度及预后的相关性OA

Objective To analyze the correlation between the expression level of serum silent in-formation regulator 1(Sirt1)and disease severity,prognosis in patients with intracerebral hemorrhage(ICH),and to evaluate its value in predicting the prognosis of ICH patients.Methods A total of 60 ICH patients were enrolled as ICH group,and 69 healthy individuals undergoing physical examination during the same period were selected as control group.Baseline data of all subjects were collected,and serum samples were obtained within 24 hours of admission.Serum Sirt1 expression levels were measured using enzyme-linked immunosorbent assay(ELISA).The degree of neurological deficit inICH pa-tients was assessed using the National Institutes of Health Stroke Scale(NIHSS)score,and patients were divided into mild(0 to 4 points,n=8),moderate(5 to 15 points,n=37),and severe(≥16 points,n=15)groups.According to the bleeding site,patients were classified into supratentori-al group(n=48)and infratentorial group(n=12).Based on the 90-day modified Rankin Scale(mRS)score,patients were categorized into favorable prognosis group(0 to 2 points,n=16)and poor prognosis group(3 to 6 points,n=44).Spearman correlation analysis was used to determine the correlations between serum Sirt1 expression level and ICH volume,Glasgow Coma Scale(GCS)score,NIHSS score,90-day mRS score in ICH patients.Logistic regression models were employed to identify independent influencing factors for the occurrence of ICH.Receiver operating characteris-tic(ROC)curves were used to evaluate the diagnostic efficacy and prognostic predictive value of se-rum Sirt1 expression level for ICH.Results The serum Sirt1 expression level in the ICH group was significantly lower than that in the control group(P＜0.05).The serum Sirt1 expression levels in the mild,moderate and severe groups showed a decreasing trend(P＜0.05).The serum Sirt1 ex-pression level in the poor prognosis group was significantly lower than that in the favorable prognosis group(P＜0.05).In the supratentorial group,serum Sirt1 expression level was negatively correla-ted with ICH volume(rs=-0.527 8,P＜0.05)and positively correlated with GCS score(rs=0.558 8,P＜0.05).In the infratentorial group,serum Sirt1 level was positively correlated with GCS score(rs=0.897 5,P＜0.05).Serum Sirt1 expression level was negatively correlated with NIHSS score and 90-day mRS score(rs=-0.804 2,-0.859 0,P＜0.05).Logistic regression analysis showed that history of hypertension and smoking were independent risk factors for ICH,while serum Sirt1 was independent protective factor(P＜0.05).The model constructed by combi-ning history of hypertension,smoking,alcohol consumption and serum Sirt1 level yielded an area under the curve(AUC)of 0.930 for diagnosing ICH.The predictive efficacy of serum Sirt1 level for ICH prognosis was excellent(AUC=0.963).Conclusion Serum Sirt1 expression level is signifi-cantly decreased in ICH patients and is closely correlated with disease severity and prognosis,sug-gesting that Sirt1 may serve as a potential biomarker for predicting the occurrence and prognosis of ICH and provide a new target for neuroprotective research.