昆明医科大学学报2025，Vol.46Issue(5)：118-125,8.DOI:10.12259/j.issn.2095-610X.S20250514
血清中血小板自噬相关因子表达参与动脉瘤性蛛网膜下腔出血患者神经功能损伤及预后的关系
Correlation between Platelet Autophagy Related Factors and Neurological Damage and Prognosis in Patients with Aneurysmal Subarachnoid Hemorrhage
摘要
Abstract
Objective To investigate the correlation between the level of platelet autophagy related factors and the neurological impairment and prognosis of the patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods From July 2020 to March 2023,90 aSAH patients admitted to the intensive care unit of neurosurgery department of our hospital were analyzed retrospectively.Based on mRS score 3 months after discharge,patients with aSAH(n=46,mRS 0-2)were divided into the good prognosis group,while those with mRS 3-5(n=44)as the poor prognosis group.Platelets of all the participants were collected,and the levels of autophagy-associated protein 7(ATG7),benzalkonium chloride 1(BECN1),microtubule-associated protein 1 light chain 3(LC3)and sequestosome 1(p62)were determined by enzyme-linked immunosorbent assay(ELISA).Results Compared with the good prognosis group,the mechanical ventilation time,ICU stay,cases of early brain injury,vasospasm and delayed cerebral ischemia in the poor prognosis group increased significantly(P<0.05).Compared with the good prognosis group,the ΔPLT in the poor prognosis group decreased significantly(P<0.05),and ΔLC3-Ⅱ and ΔATG7 increased significantly(P<0.05).Spearman correlation analysis showed that ΔPLT was positively correlated with ΔATG7,ΔLC3-Ⅱ and ΔBECN1(r=0.239,0.389 and 0.487,all P<0.05).Platelet ΔLC3-Ⅱ in patients with vasospasm and delayed cerebral ischemia was higher than that in patients without vasospasm and delayed cerebral ischemia(P<0.05).ICU stay(OR=1.187,95%CI=1.045～1.349,P=0.008),ΔPLT(OR=0.972,95%CI=0.947～0.998,P=0.034)and ΔLC3-Ⅱ(OR=2.840,95%CI=1.049～7.694,P=0.040)were independent influencing factors for the poor prognosis of aSAH patients.The combination of ICU stay,ΔPLT and ΔLC3-Ⅱ had the greatest ability to predict the poor prognosis of aSAH patients,with AUC of 0.921,sensitivity of 86.4%and specificity of 84.8%.Conclusion The decrease of platelet count and LC3-Ⅱ improvement in early treatment of aSAH patients can be regarded as the independent influencing factors of adverse outcomes.关键词
动脉瘤性蛛网膜下腔出血/血小板/自噬/神经功能损伤/预后Key words
Aneurysmal subarachnoid hemorrhage/Platelets/Autophagy/Nerve function damage/Prognosis分类
临床医学引用本文复制引用
方园,吴昆仑,张仕涛,冯阳..血清中血小板自噬相关因子表达参与动脉瘤性蛛网膜下腔出血患者神经功能损伤及预后的关系[J].昆明医科大学学报,2025,46(5):118-125,8.基金项目
陕西省卫生健康委科研课题(2023PT058) （2023PT058）
西安市科协项目(959202313026) （959202313026）
