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瘦素的预后价值:脑出血患者的6个月结局

Prognostic value of leptin: 6-month outcome in patients with intracerebral hemorrhage.

作者信息

Zhang Xin, Lu Xiao-Min, Huang Li-Fa, Li Xu

机构信息

Department of Neurosurgery, Traditional Chinese Medical Hospital of Zhejiang Province, 54 Youdian Road, Hangzhou 310006, China.

出版信息

Peptides. 2013 May;43:133-6. doi: 10.1016/j.peptides.2013.03.010. Epub 2013 Mar 18.

Abstract

Leptin has recently been discussed as a novel biomarker for the clinical outcome of critical illness. This study aims to investigate the prognostic value of leptin with regard to long-term clinical outcomes in patients with intracerebral hemorrhage. In 50 healthy controls and 92 patients with acute spontaneous basal ganglia hemorrhage presenting to the emergency department of a large primary care hospital, we measured plasma leptin levels using an enzyme-linked immunosorbent assay in a blinded fashion. Plasma leptin levels on admission were considerably higher in patients than healthy controls. A significant correlation emerged between plasma leptin level and National Institutes of Health Stroke Scale score. A multivariate analysis identified plasma leptin level as an independent predictor for 6-month clinical outcomes including 6-month mortality and unfavorable outcome (Modified Rankin Scale score>2). Using receiver operating characteristic curves, we calculated areas under the curve for 6-month clinical outcomes. The predictive performance of leptin was similar to, but did not obviously improve that of National Institutes of Health Stroke Scale scores. Thus, leptin may help in the prediction of 6-month mortality and unfavorable outcome after intracerebral hemorrhage.

摘要

近年来,瘦素作为危重病临床结局的一种新型生物标志物受到了讨论。本研究旨在探讨瘦素对脑出血患者长期临床结局的预后价值。在一家大型初级保健医院急诊科就诊的50名健康对照者和92例急性自发性基底节脑出血患者中,我们采用酶联免疫吸附测定法以盲法测量血浆瘦素水平。患者入院时的血浆瘦素水平显著高于健康对照者。血浆瘦素水平与美国国立卫生研究院卒中量表评分之间存在显著相关性。多变量分析确定血浆瘦素水平是6个月临床结局(包括6个月死亡率和不良结局(改良Rankin量表评分>2))的独立预测因素。使用受试者工作特征曲线,我们计算了6个月临床结局的曲线下面积。瘦素的预测性能与美国国立卫生研究院卒中量表评分相似,但并未明显改善其预测性能。因此,瘦素可能有助于预测脑出血后的6个月死亡率和不良结局。

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