血清缺氧诱导因子1α水平与脑出血后的预后相关。

Serum Hypoxia-Inducible Factor 1alpha Levels Correlate with Outcomes After Intracerebral Hemorrhage.

作者信息

Cai Yong, Zhuang Yao-Kun, Wu Xiao-Yu, Dong Xiao-Qiao, Du Quan, Yu Wen-Hua, Wang Ke-Yi, Hu Wei, Zheng Yong-Ke

机构信息

The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang Province, People's Republic of China.

Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang Province, People's Republic of China.

出版信息

Ther Clin Risk Manag. 2021 Jul 13;17:717-726. doi: 10.2147/TCRM.S313433. eCollection 2021.

BACKGROUND

Serum hypoxia-inducible factor 1alpha (HIF-1α) is a key regulator in hypoxic and ischemic brain injury. We determined the relationship between serum HIF-1α levels and long-term prognosis plus severity of intracerebral hemorrhage (ICH).

METHODS

A total of 97 ICH cases and 97 healthy controls were enrolled. Glasgow Coma Scale (GCS) score and hematoma volume were used to assess hemorrhagic severity. Glasgow Outcome Scale (GOS) score of 1-3 at post-stroke 90 days was defined as a poor outcome.

RESULTS

Serum HIF-1α levels of ICH patients were significantly higher than those of healthy controls (median, 218.8 vs 105.4 pg/mL; P<0.001) and were substantially correlated with GCS score (=-0.485, P<0.001), hematoma volume (=0.357, P<0.001) and GOS score (=-0.436, P<0.001). Serum HIF-1α levels >239.4 pg/mL discriminated patients at risk of 90-day poor outcome with sensitivity of 65.9% and specificity of 79.3% (area under the receiver operating characteristic curve, 0.725; 95% confidence interval, 0.625-0.811; P<0.001). Moreover, serum HIF-1α levels >239.4 pg/mL were independently associated with a poor 90-day outcome (odds ratio, 5.133; 95% confidence interval, 1.117-23.593; P=0.036).

CONCLUSION

Serum HIF-1α, in close correlation with hemorrhagic severity and poor 90-day outcome, may serve as a potential prognostic biomarker for ICH.

背景

血清缺氧诱导因子1α（HIF-1α）是缺氧缺血性脑损伤的关键调节因子。我们确定了血清HIF-1α水平与脑出血（ICH）长期预后及严重程度之间的关系。

方法

共纳入97例ICH患者和97例健康对照。采用格拉斯哥昏迷量表（GCS）评分和血肿体积评估出血严重程度。卒中后90天格拉斯哥预后量表（GOS）评分为1-3分定义为预后不良。

结果

ICH患者血清HIF-1α水平显著高于健康对照（中位数分别为218.8与105.4 pg/mL；P<0.001），且与GCS评分（r=-0.485，P<0.001）、血肿体积（r=0.357，P<0.001）和GOS评分（r=-0.436，P<0.001）显著相关。血清HIF-1α水平>239.4 pg/mL可鉴别90天预后不良风险患者，敏感性为65.9%，特异性为79.3%（受试者工作特征曲线下面积为0.725；95%置信区间为0.625-0.811；P<0.001）。此外，血清HIF-1α水平>239.4 pg/mL与90天预后不良独立相关（比值比为5.133；95%置信区间为1.117-23.593；P=0.036）。