高血压性脑出血患者血清ITIH4、CIRP、NINJ1水平变化及与神经功能缺损和预后的关系OA

Objective To investigate the changes in serum levels of inter-alpha-trypsin inhibitor heavy chain H4(ITIH4),cold-inducible RNA-binding protein(CIRP),and nerve injury-induced protein 1(NINJ1)in patients with hypertensive intracerebral hemorrhage(HICH),and their relationship with neurological deficits and prognosis.Methods A total of 191 HICH patients admitted to Handan First Hospital between January 2022 and January 2024 were selected as the study subjects,all of whom underwent minimally invasive intracranial hematoma puncture and drainage.According to the National Institutes of Health Stroke Scale(NIHSS)scores,patients were assigned to a mild deficit group of 63 cases,a moderate deficit group of 71 cases,and a severe deficit group of 57 cases.Based on the 6-month post-discharge prognosis,they were assigned into a good prognosis group 108 cases and a poor prognosis group 83 cases.ELISA was applied to detect serum levels of ITIH4,CIRP,and NINJ1.Pearson correlation analysis was applied to assess the correlation between serum ITIH4,CIRP,NINJ1 levels and NIHSS scores.Multivariate Logistic regression was applied to analyze factors affecting the poor prognosis in HICH patients.ROC curve was applied to analyze the predictive value of serum ITIH4,CIRP,and NINJ1 levels for poor prognosis in HICH patients.Results Serum ITIH4 level in HICH patients was lower in the severe neurological deficit group than in the moderate and mild deficit groups,while serum CIRP and NINJ1 levels were higher in the severe deficit group compared to the moderate and mild deficit groups(P<0.05).Serum ITIH4 level was negatively correlated with NIHSS score(r=-0.524,P<0.05),whereas serum CIRP and NINJ1 levels were positively correlated with NIHSS scores(r=0.351,0.403;P<0.05).Compared with the good prognosis group,the poor prognosis group had lower serum ITIH4 level and higher proportions of intraoperative hemorrhage≥50 mL,hematoma clearance rate<80ﾣ,and intraventricular extension,as well as higher preoperative Glasgow Coma Scale(GCS)scores and serum CIRP and NINJ1 levels,with statistically significant differences(P<0.05).Intraoperative hemorrhage,hematoma clearance rate,intraventricular extension,preoperative GCS score,and serum levels of ITIH4,CIRP,and NINJ1 were identified as influencing factors for the poor prognosis in HICH patients(OR=1.549,1.695,1.916,1.352,0.637,2.917,3.265,respectively;P<0.05).The combined predictive value of serum ITIH4,CIRP,and NINJ1 levels for the poor prognosis in HICH patients yielded an area under the ROC curve(AUC)of 0.937,which was superior to the predictive performance of each biomarker alone(Z=3.695,3.385,3.210,respectively;P<0.05).Conclusion Changes in serum levels of ITIH4,CIRP,and NINJ1 in HICH patients are related to neurological deficits and prognosis.The combined detection of three biomarkers has clinical significance in predicting poor prognosis in HICH patients.