急性脑出血后血清半胱天冬酶裂解细胞角蛋白18浓度的预测价值

Predictive value of serum caspase-cleaved cytokeratin-18 concentrations after acute intracerebral hemorrhage.

作者信息

Gu Shui-Jun, Lu Ming, Xuan Hong-Fei, Chen Xin-Zhi, Dong Wei-Feng, Yan Xiao-Feng, Si Yun, Gao Guo-Liang, Hu Dian-Xiang, Miao Jian-Qing

机构信息

Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China.

出版信息

Clin Chim Acta. 2016 Jan 15;452:124-8. doi: 10.1016/j.cca.2015.11.011. Epub 2015 Nov 10.

DOI:10.1016/j.cca.2015.11.011

PMID:26569346

Abstract

BACKGROUND

Caspase-cleaved Cytokeratin-18 (CCCK-18) is released during apoptosis. Serum CCCK-18 concentrations are associated with prognosis of some critical illness. We investigated the potential relationships between serum CCCK-18 concentrations and disease severity and long-term clinical outcomes after intracerebral hemorrhage.

METHODS

Serum CCCK-18 concentrations were determined in a total of 102 patients and 102 controls. Multivariate models were used to predict high concentration of CCCK-18 and 6-month clinical outcomes. The predictive values were evaluated based on areas under receiver operating curve.

RESULTS

Compared with controls, serum CCCK-18 concentrations were increased in patients (245.8±108.3U/l vs. 23.6±18.1U/l, P<0.001). National Institute of Health Stroke Scale scores [odds ratio (OR), 1.164; 95% confidence interval (CI), 1.027-1.320; P=0.003] and hematoma volumes (OR, 1.079; 95% CI, 1.018-1.205; P=0.008) were independent predictors of high concentration of CCCK-18. CCCK-18 was identified as an independent predictor of 6-month mortality (OR, 1.019; 95% CI, 1.010-1.038; P=0.013) and 6-month unfavorable outcome (OR, 1.017; 95% CI, 1.008-1.029; P=0.032) and possessed high predictive values.

CONCLUSION

Increased serum CCCK-18 concentrations are associated with disease severity and clinical outcomes, suggesting that CCCK represent a novel prognostic predictive biomarker after intracerebral hemorrhage.

摘要

背景

半胱天冬酶切割的细胞角蛋白-18（CCCK-18）在细胞凋亡过程中释放。血清CCCK-18浓度与一些危重病的预后相关。我们研究了血清CCCK-18浓度与脑出血后疾病严重程度和长期临床结局之间的潜在关系。

方法

共测定了102例患者和102例对照的血清CCCK-18浓度。采用多变量模型预测CCCK-18的高浓度和6个月的临床结局。基于受试者工作特征曲线下面积评估预测价值。

结果

与对照组相比，患者血清CCCK-18浓度升高（245.8±108.3U/l对23.6±18.1U/l，P<0.001）。美国国立卫生研究院卒中量表评分[比值比（OR），1.164；95%置信区间（CI），1.027-1.320；P=0.003]和血肿体积（OR，1.079；95%CI，1.018-1.205；P=0.008）是CCCK-18高浓度的独立预测因素。CCCK-18被确定为6个月死亡率（OR，1.019；95%CI，1.010-1.038；P=0.013）和6个月不良结局（OR，1.017；95%CI，1.008-1.029；P=0.032）的独立预测因素，且具有较高的预测价值。