【摘要】 目的 探讨血清中基质衍生因子-1(Stromal cell-derived factor 1,SDF-1)与趋化因子受体4(C-X-C chemokine receptor type 4,CXCR4)对高血压脑出血早期血肿扩大的预测作用。方法 我院2020年1月～2022年6月收治的高血压脑出血病人79例。根据入院后头颅CT复查结果显示血肿是否扩大分为血肿扩大组和血肿未扩大组，将两组病人在发病后首次头颅CT检查的血肿部位、血肿形态、入院后收缩压水平、血肿密度是否均匀、入院GCS评分及血清中SDF-1与CXCR4等指标进行比较。受试者工作特征曲线(receiver operator characteristic curve, ROC曲线)评估SDF-1与CXCR4的预测价值。结果 79例高血压脑出血病人中，出血增加21例。单因素分析结果表明，血肿形态、入院GCS评分、收缩压水平、血肿密度是否均匀，差异有统计学意义(均P<0.05)。Logistic多因素分析显示，SDF-1与CXCR4是高血压脑出血早期血肿扩大的独立危险因素(OR分别为1.460、1.362,95%CI分别为1.056～2.018、1.200～1.547,P<0.05)。ROC曲线分析结果显示，SDF-1的AUC为0.868(95%CI为0.688～1.000,P<0.005),特异性为0.875,敏感性为0.778。CXCR4的AUC为0.758(95%CI为0.557～0.948,P<0.05),特异性为0.750,敏感性为0.733。结论 高血压脑出血病人SDF-1与CXCR4的表达显著升高，同时与高血压脑出血早期血肿扩大有关，SDF-1与CXCR4预测高血压脑出血早期血肿扩大的敏感度与特异度均较高。更多还原

【Abstract】 Objective To explore the predictive effect of serum Stromal cell-derived factor 1(SDF-1)and C-X-C chemokine receptor type 4(CXCR4)on early hematoma enlargement in hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 79 patients with HICH in our hospital from January 2020 to June 2022 were retrospectively analyzed.According to the results of head CT reexamination after admission, the patients were divided into hematoma enlargement group and hematoma non enlargement group.The hematoma location of the first head CT examination, hematoma shape, systolic blood pressure level after admission, hematoma density uniformity, admission GCS score and serum SDF-1 and CXCR4 were compared between the two groups.Receiver operator characteristic curve(ROC) was used to evaluate the predictive value of SDF-1 and CXCR4.Results Among 79 patients with HICH,21 patients had increased bleeding.Univariate analysis showed that there were significant differences in hematoma shape, admission GCS score, systolic blood pressure and hematoma density between the two groups(all P<0.05).Logistic multivariate analysis showed that SDF-1 and CXCR4 were independent risk factors for hematoma enlargement in early stage of hypertensive intracerebral hemorrhage(respectively OR:1.460,1.362,respectively 95%CI:1.056 ～ 2.018,1.200 ～ 1.547,all P<0.05).ROC curve analysis showed that AUC of SDF-1 was 0.868(95%CI:0.688-1.000,P<0.005),specificity was 0.875,sensitivity was 0.778.The AUC of CXCR4 was 0.758(95%CI:0.557-0.948,P<0.05),the specificity was 0.750,and the sensitivity was 0.733.Conclusion The expression of SDF-1 and CXCR4 in patients with HICH is significantly increased, which is related to the early hematoma enlargement.SDF-1 and CXCR4 have high sensitivity and specificity in predicting the early hematoma enlargement in HICH.更多还原