【摘要】 目的：探讨颅内压参数联合血清小窝蛋白-1(caveolin-1)、水通道蛋白4(AQP-4)对高血压脑出血（HICH）患者术后预后不良的预测价值。方法：选择2020年1月至2022年1月河北省胸科医院收治的106例HICH患者，术后随访3个月，根据格拉斯哥预后（GOS）评分将患者分为预后良好组（55例），预后不良组（51例）。术后监测颅内压参数[压力反应指数（PRx）、平均颅内压波幅（MWA）、20 mm Hg阈值下颅内压剂量（Dicp20）]，检测血清caveolin-1、AQP-4水平。多因素Logistic回归分析HICH患者术后预后不良的因素。受试者工作特征曲线（ROC）分析颅内压参数联合血清caveolin-1、AQP-4预测HICH患者术后预后不良的价值。结果：预后不良组PRx、MWA、Dicp20以及血清caveolin-1、AQP-4水平高于预后良好组（P<0.05）。低术前格拉斯哥昏迷评分（GCS）评分、高PRx、高Dicp20、高caveolin-1、高AQP-4是HICH患者术后预后不良的危险因素（P<0.05）。联合PRx、Dicp20、caveolin-1和AQP-4预测HICH患者术后3个月预后不良的的曲线下面积为0.823，大于PRx、Dicp20、caveolin-1和AQP-4单独预测。结论：高PRx、Dicp20、caveolin-1、AQP4是HICH患者术后预后不良的危险因素，联合颅内压参数PRx、Dicp20及血清caveolin-1、AQP4预测HICH患者术后预后不良具有较高的价值。更多还原

【Abstract】 Objective: To explore the predictive value of intracranial pressure parameters combined with serum caveolin-1 and aquaporin-4(AQP-4) on the poor prognosis of patients with hypertensive intracerebral hemorrhage(HICH) after operation. Methods: 106patients with HICH who were admitted to Hebei Provincial Chest Hospital from January 2020 to January 2022 were selected, and the patients were followed up for 3 months after operation. The patients were divided into good prognosis group(55 cases) and poor prognosis group(51 cases) according to Glasgow Outcome Scale(GOS) score. Intracranial pressure parameters [pressure response index(PRx), mean wave amplitude(MWA) and intracranial pressure dose under the threshold of 20 mm Hg(Dicp20) ]were monitored after operation, and serum caveolin-1 and AQP-4 levels were detected. Multivariate logistic regression was used to analyze the factors of poor prognosis in patients with HICH after operation. The value of intracranial pressure parameters combined with serum caveolin-1 and AQP-4 in predicting postoperative poor prognosis of patients with HICH was analyzed by receiver operating characteristic curve(ROC).Results: The PRx, MWA, Dicp20 and serum caveolin-1, AQP-4 levels in the poor prognosis group were higher than those in the good prognosis group(P <0.05). Low preoperative Glasgow coma score(GCS) score, high PRx, high Dicp20, high caveolin-1 and high AQP-4 were risk factors for poor prognosis of HICH(P<0.05). The area under the curve of combining PRx, Dicp20, caveolin-1 and AQP-4 to predict poor prognosis of HICH patients at 3 months after operation was 0.823, which was larger than that predicted by PRx,Dicp20, caveolin-1 and AQP-4 alone. Conclusion: High PRx, Dicp20, caveolin-1 and AQP4 are risk factors for postoperative poor prognosis in patients with HICH, and the combination of intracranial pressure parameters PRx, Dicp20 and serum caveolin-1, AQP4 has a high value in predicting postoperative poor prognosis in patients with HICH.更多还原