血清Kal、TREM-1对高血压性脑出血患者病情严重程度及预后的影响OACSTPCD

Objective To investigate the effects of serum human kallikrein binding protein(Kal)and trig-gering receptor expressed on myeloid cells-1(TREM-1)on the severity and prognosis of patients with hyper-tensive cerebral hemorrhage(HICH).Methods A total of 180 patients with HICH admitted to the hospital from January 2020 to March 2023 were selected as the HICH group,and 180 healthy people who underwent physical examination in the hospital during the same period were selected as the control group.According to the severity of the disease in patients with HICH were divided into mild group,moderate group and severe group.According to the prognosis of the patients,they were divided into good prognosis group and poor prog-nosis group.The basic data of patients with HICH were collected,and Kal and TREM-1 levels of study sub-jects were detected.Multivariate Logistic regression was used to analyze the risk factors of poor prognosis in patients with HICH.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum Kal and TREM-1 for poor prognosis of HICH patients.Results The level of serum Kal in HICH group was significantly lower than that in control group,and the level of TREM-1 l in HICH group was significantly higher than that in control group(P＜0.05).There were 56 patients in the mild group,82 pa-tients in the moderate group and 42 patients in the severe group.The severe group had a significantly lower serum Kal level than the mild group and the moderate group,and the moderate group had a significantly lower serum Kal level than the mild group(P＜0.05).The severe group had a significantly higher serum TREM-1 level than the mild and moderate groups,and the moderate group had a significantly higher serum TREM-1 level than the mild group(P＜0.05).There were 122 patients in the good prognosis group and 58 patients in the poor prognosis group.The proportion of patients with a history of hypertension,TREM-1 level and blood loss in the poor prognosis group were higher than those in the good prognosis group,and Kal level in the poor prognosis group was lower than that in the good prognosis group(P＜0.05).There was no significant differ-ence in age,proportion of males,body mass index and diabetes history between the good prognosis group and the poor prognosis group(P＞0.05).Multivariate Logistic regression analysis showed that the history of hy-pertension,increased TREM-1 level,large blood loss and decreased Kal level were independent risk factors for poor prognosis in HICH patients(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of the combination of the two indexes for predicting poor prognosis of HICH patients was 0.920,which was higher than 0.857 and 0.860 predicted by Kal and TREM-1 alone(Z=2.765 and 2.324,P=0.006 and 0.020).Conclusion The decrease of serum Kal level and the increase of TREM-1 level in patients with HICH are closely related to the severity and prognosis of patients with HICH.The combined detection of these two indexes has a high predictive value for the poor prognosis of patients with HICH.