Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, China.
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
CNS Neurosci Ther. 2024 Mar;30(3):e14450. doi: 10.1111/cns.14450. Epub 2023 Sep 18.
Perihematomal edema (PHE) is one of the severe secondary damages following intracranial hemorrhage (ICH). Studies showed that blood-brain barrier (BBB) injury contributes to the development of PHE. Previous studies showed that occludin protein is a potential biomarker of BBB injury. In the present study, we investigated whether the levels of serum occludin on admission are associated with PHE volumes in ICH patients.
This cross-sectional study included 90ICH patients and 32 healthy controls.The volumes of hematoma and PHE were assessed using non-contrast cranial CT within 30 min of admission. Blood samples were drawn on admission, and the levels of baseline serum occludin were detected using enzyme-linked immunosorbent assay. Partial correlation analysis and multiple linear regression analysis were performed to evaluate the association between serum occludin levels and PHE volumes in ICH patients.
The serum occludin levels in ICH patients were much higher than health controls (median 0.27 vs. 0.13 ng/mL, p < 0.001). At admission, 34 ICH patients (37.78%) had experienced a severe PHE (≥30 mL), and their serum occludin levels were higher compared to those with mild PHE (<30 mL) (0.78 vs. 0.21 ng/mL, p < 0.001). The area under the receiver operating characteristics curve (ROC) of serum occludin level in predicting severe PHE was 0.747 (95% confidence interval CI 0.644-0.832, p < 0.001). There was a significant positive correlation between serum occludin levels and PHE volumes (partial correlation r = 0.675, p < 0.001). Multiple linear regression analysis showed that serum occludin levels remained independently associated with the PHE volumes after adjusting other confounding factors.
The present study showed that serum occludin levels at admission were independently correlated with PHE volumes in ICH patients, which may provide a biomarker indicating PHE volume change.
血肿周围水肿（PHE）是颅内出血（ICH）后严重的继发性损伤之一。研究表明，血脑屏障（BBB）损伤导致 PHE 的发展。先前的研究表明，紧密连接蛋白（occludin）是 BBB 损伤的潜在生物标志物。在本研究中，我们研究了入院时血清 occludin 水平是否与 ICH 患者的 PHE 体积有关。
本横断面研究纳入了 90 例 ICH 患者和 32 例健康对照者。入院 30 分钟内通过非对比性头颅 CT 评估血肿和 PHE 体积。入院时采集血样，采用酶联免疫吸附试验检测基础血清 occludin 水平。采用偏相关分析和多元线性回归分析评估 ICH 患者血清 occludin 水平与 PHE 体积之间的关系。
ICH 患者的血清 occludin 水平明显高于健康对照组（中位数 0.27 比 0.13ng/mL，p<0.001）。入院时，34 例 ICH 患者（37.78%）发生严重 PHE（≥30ml），其血清 occludin 水平高于轻度 PHE（<30ml）患者（0.78 比 0.21ng/mL，p<0.001）。血清 occludin 水平预测严重 PHE 的受试者工作特征曲线（ROC）下面积为 0.747（95%置信区间 0.644-0.832，p<0.001）。血清 occludin 水平与 PHE 体积之间存在显著正相关（偏相关 r=0.675，p<0.001）。多元线性回归分析表明，调整其他混杂因素后，血清 occludin 水平仍与 PHE 体积独立相关。
本研究表明，入院时血清 occludin 水平与 ICH 患者的 PHE 体积独立相关，可能为预测 PHE 体积变化的生物标志物。
