临床外科杂志 ›› 2023, Vol. 31 ›› Issue (9): 830-833.doi: 10.3969/j.issn.1005-6483.2023.09.009

• 论著 • 上一篇    下一篇

脑出血病人血清P2X7R水平与脑水肿程度及认知功能相关性研究

  

  1. 061002 河北省沧州市人民医院神经外科
  • 收稿日期:2022-12-30 出版日期:2023-09-20 发布日期:2023-09-20
  • 通讯作者: 王玉华,Email:Z15350571386@126.com

Correlation of serum P2X7R level with the degree of cerebral edema and cognitive function in patients with cerebral hemorrhage

  1. Department of Neurosurgery,Cangzhou People’s Hospital,Hebei,Cangzhou 061000, China
  • Received:2022-12-30 Online:2023-09-20 Published:2023-09-20

摘要: 目的 检测脑出血病人血清胞膜上嘌呤配体P2X门控离子通道型受体7(P2X7R)水平以及脑水肿程度,并分析二者与脑出血病人认知功能障碍的相关性。方法 前瞻性选取2019年7月~2021年7月本院收治的115例脑出血病人为研究组,另取同期体检健康者90例为健康对照组。检测血清P2X7R水平以及脑水肿体积;采用Pearson分析血清P2X7R水平与脑水肿体积的相关性;根据病人是否出现认知功能障碍分为无认知功能障碍组(78例)和认知功能障碍组(37例),多因素Logistic回归分析脑出血病人认知功能障碍的影响因素,绘制血清P2X7R水平与脑水肿体积对脑出血病人认知功能评估的ROC曲线。结果 研究组病人发病第1 天时血清P2X7R水平高于健康对照组(P<0.05),脑出血病人血清P2X7R水平、脑水肿体积在1~5 天出现逐渐升高的趋势,在第5 天达到峰值然后降低(P<0.05);脑出血病人发病第1、3、5、7 天血清P2X7R水平与脑水肿体积均呈正相关(r=0.712、0.583、0.589、0.472,P<0.05);认知功能障碍组血清P2X7R水平、脑水肿体积均高于无认知功能障碍组(P<0.05);血清P2X7R水平、脑水肿体积是影响脑出血病人认知功能的危险因素(P<0.05);血清P2X7R水平、脑水肿体积单独及联合预测病人认知功能障碍的曲线下面积分别是0.763、0.750和0.829。结论 脑出血病人血清P2X7R水平升高,脑水肿体积增大,二者呈正相关,联合检测可预测病人认知功能障碍的发生。

关键词: 脑出血, 胞膜上嘌呤配体P2X门控离子通道型受体7, 脑水肿, 认知功能

Abstract: Objective To detect the level of purinergic receptor P2X,ligandgated ion channel 7 (P2X7R) and the degree of cerebral edema in patients with cerebral hemorrhage,and to analyze the correlation between the two and the cognitive function of patients with cerebral hemorrhage. Methods Prospectively,115 patients with cerebral hemorrhage admitted to our hospital from July 2019 to July 2021 were regarded as the study group.Another 90 healthy subjects who underwent physical examination were regarded as the healthy control group.The serum P2X7R level and the volume of cerebral edema were detected;Pearson correlation was used to analyze the correlation between P2X7R and brain edema volume;the patients were grouped into a no cognitive dysfunction group (78 cases) and a cognitive dysfunction group (37 cases) according to whether cognitive dysfunction occurred,multivariate Logistic regression was performed to analyze the cognitive function factors of patients with cerebral hemorrhage,receiver operating characteristic (ROC) curve of serum P2X7R level and brain edema volume in the assessment of cognitive function in patients with intracerebral hemorrhage was drawn. Results On the first day of onset,the serum P2X7R level in the study group were higher than those in the healthy control group (P<0.05),the serum P2X7R level and the volume of cerebral edema in patients with cerebral hemorrhage gradually increased during 1-5d,and reached the peak on the 5th day and then decreased (P<0.05);there were a positive correlation between serum P2X7R levels and brain edema volume in patients with cerebral hemorrhage on the 1st,3rd,5th,and 7th day of onset (r=0.712,0.583,0.589,0.472,P<0.05);the serum P2X7R level and brain edema volume in the Cognitive dysfunction group were higher than those in the no cognitive dysfunction group (P<0.05);serum P2X7R levels and brain edema volume are risk factors for cognitive dysfunction in patients with cerebral hemorrhage (P<0.05).The area under the curve of serum P2X7R level and cerebral edema volume alone and in combination was 0.763,0.750 and 0.829,respectively. Conclusion The level of serum P2X7R in patients with cerebral hemorrhage increases,and the volume of cerebral edema increases,and the two are positively correlated.Combined detection can predict the occurrence of cognitive dysfunction in patients.

Key words: cerebral hemorrhage, purinergic receptor P2X ligand-gated ion channel 7, cerebral edema, cognitive function

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