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血浆瘦素水平可预测急性脑出血后血肿扩大和早期神经功能恶化。

Plasma leptin level predicts hematoma growth and early neurological deterioration after acute intracerebral hemorrhage.

机构信息

Department of Neurosurgery, The First People's Hospital of Hangzhou, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China.

出版信息

Peptides. 2013 Jul;45:35-9. doi: 10.1016/j.peptides.2013.04.017. Epub 2013 May 6.

Abstract

Higher plasma leptin levels have been associated with poor clinical outcomes after intracerebral hemorrhage. Nevertheless, their links with hematoma growth and early neurological deterioration are unknown. Therefore, we aimed to investigate the relationship between plasma leptin levels, hematoma growth, and early neurological deterioration in patients with acute intracerebral hemorrhage. We prospectively studied 102 consecutive patients with acute spontaneous basal ganglia hemorrhage presenting within 6h from symptoms onset. Significant hematoma growth was defined as hematoma enlargement >33% at 24h. Early neurological deterioration was defined as an increase of ≥4 points in National Institute of Health Stroke Scale score at 24h from symptoms onset. We measured plasma leptin levels on admission using an enzyme-linked immunosorbent assay in a blinded fashion. In multivariate logistic regression analysis, plasma leptin level emerged as the independent predictor of hematoma growth (odds ratio, 1.182; 95% confidence interval, 1.061-2.598; P=0.008) and early neurological deterioration (odds ratio, 1.193; 95% confidence interval, 1.075-2.873; P=0.004). Using receiver operating characteristic curves, we calculated areas under the curve for hematoma growth (area under curve, 0.844; 95% confidence interval, 0.759-0.908) and early neurological deterioration (area under curve, 0.857; 95% confidence interval, 0.774-0.918). The predictive performance of leptin was similar to, but did not obviously improve that of hematoma volume. Thus, leptin may help in the prediction of hematoma growth and early neurological deterioration after intracerebral hemorrhage.

摘要

较高的血浆瘦素水平与脑出血后不良临床结局相关。然而,其与血肿扩大和早期神经功能恶化的关系尚不清楚。因此,我们旨在研究脑出血患者血浆瘦素水平与血肿扩大和早期神经功能恶化的关系。我们前瞻性研究了 102 例发病 6 小时内的急性自发性基底节脑出血患者。血肿显著增大定义为 24 小时内血肿扩大>33%。早期神经功能恶化定义为发病 24 小时内 NIHSS 评分增加≥4 分。我们采用酶联免疫吸附试验以盲法检测入院时的血浆瘦素水平。在多变量 logistic 回归分析中,血浆瘦素水平是血肿扩大的独立预测因子(优势比,1.182;95%置信区间,1.061-2.598;P=0.008)和早期神经功能恶化(优势比,1.193;95%置信区间,1.075-2.873;P=0.004)。通过接受者操作特征曲线,我们计算了血肿扩大(曲线下面积,0.844;95%置信区间,0.759-0.908)和早期神经功能恶化(曲线下面积,0.857;95%置信区间,0.774-0.918)的曲线下面积。瘦素的预测性能与血肿量相似,但并未明显改善。因此,瘦素可能有助于预测脑出血后血肿扩大和早期神经功能恶化。

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