关键词: 基底节区脑出血, 神经内镜清除术, 高迁移率族蛋白, 巨噬细胞炎症蛋白-1α, 骨桥蛋白

Abstract: Objective  To investigate the relationship between preoperative serum high mobility group protein 1(HMGB1),macrophage inflammatory protein-1α (MIP-1α),osteopontin (OPN) and the prognosis of patients with basal ganglia intracerebral hemorrhage after neuroendoscopic surgery.Methods From March 2022 to March 2024,98 patients with cerebral hemorrhage in basal ganglia treated by neuroendoscopic removal were selected.Serum HMGB1,MIP-1 a and OPN were detected before operation,and they were followed up for 1 month after operation.Cox-regression analysis was used to analyze the risk factors affecting the prognosis of patients with cerebral hemorrhage in basal ganglia.Kapla-Meier survival curve and Log-rank test were used to analyze the survival rate of patients with cerebral hemorrhage in basal ganglia.Results Among the 98 patients with cerebral hemorrhage in basal ganglia,21 patients died within 1 month after neuroendoscopic removal,and the mortality rate was 21.43%.The proportion of patients with midline shift ≥ 10mm（76.19%） and hematoma volume[（51.18±7.62）ml] in the death group were higher than those in the survival group[14.29% and (31.93±5.66）ml],and the hematoma clearance rate[（78.13±5.86）%] was lower than that in the survival group[（90.58±6.29）%] (P<0.05).The preoperative levels of HMGB1, MIP-1 α and OPN in the death group were (12.44±2.26)ng/ml, (417.25 ±134.12)pg/ml and (12.32±3.19)ng/ml, respectively.The survival groups were (7.52±2.37)ng/ml, (200.35±31.36)pg/ml and (6.29±2.37)ng/ml,respectively. There was a statistically significant difference between the two groups (P<0.05).Cox regression analysis showed that preoperative high HMGB1 (HR=1.629,95%CI:1.274-2.083),high MIP-1α (HR=2.875,95%CI:1.384-5.972),high- OPN (HR=1.429,95%CI:1.073-1.093) were risk factors for death within 1 month after neuroendoscopic removal of basal ganglia intracerebral hemorrhage (P<0.05).Survival curve analysis showed that the survival rate of high HMGB1,high MIP-1α and high OPN at 1 month after operation was significantly lower than that of low HMGB1,low MIP-1α and low OPN (Long-rank- χ2 = 7.539,6.028,8.220,P<0.05).Conclusion The prognosis of patients with basal ganglia intracerebral hemorrhage with high HMGB1,high MIP-1α and high OPN before neuroendoscopic surgery was poor.Preoperative HMGB1,MIP-1α and OPN may be used as indicators for postoperative evaluation of neuroendoscopic removal in patients with basal ganglia intracerebral hemorrhage.

Key words: cerebral hemorrhage in basal ganglia, neuroendoscopic removal, high mobility group proteins, macrophage inflammatory protein-1α, osteopontin