水肿体积 MMP-9 NSE与基底节脑出血外侧裂入路手术疗效的关系及预后预测价值

doi:10.3969/j.issn.1006-6233.2021.09.009

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Abstract Objective: To explore the relationship between edema volume, matrix metalloproteinase-9 (MMP-9), neuron-specific enolase (NSE) and the curative effect of the lateral fissure approach of basal ganglia intracerebral hemorrhage, and analyze the prognostic value of each index. Methods: 150 patients with basal ganglia cerebral hemorrhage admitted to our hospital from May 2019 to August 2020 were selected for surgical treatment of lateral fissure approach. According to the effect of surgical treatment, they were divided into effective group and ineffective group. The clinical data, relative perihematomal edema (rPHE) and serum MMP-9 and NSE levels before and after treatment were compared between the two groups. The Pearson correlation coefficient model was used to analyze the correlation between rPHE, serum MMP-9, NSE and the patient's neurological function (NHISS score), and the logistic regression model was used to analyze the factors affecting the surgical efficacy. Follow-up for 3 months after treatment, the prognosis of the patients was counted, and the levels of rPHE and serum MMP-9 and NSE in patients with different prognosis were compared after surgical treatment. The receiver operating characteristic (ROC) curve was used to analyze the prognostic value of rPHE, serum MMP-9, and NSE after surgical treatment.Results: The NIHSS score, hematoma volume, serum MMP-9 and NSE levels before and after treatment in the effective group were lower than those in the ineffective group, and rPHE before and after treatment was higher than that in the ineffective group (P<0.05). Before treatment, NHISS score of patients with basal ganglia intracerebral hemorrhage was negatively correlated with rPHE, and positively correlated with serum MMP-9 and NSE levels (P<0.05). Before treatment, NIHSS score, hematoma volume, rPHE, serum MMP-9, and NSE levels were all influencing factors for the curative effect of lateral fissure approach surgery in patients with basal ganglia intracerebral hemorrhage (P<0.05). The rPHE of patients with good prognosis after surgical treatment was higher than that of patients with poor prognosis, and the levels of serum MMP-9 and NSE were lower than those with poor prognosis (P<0.05). After surgical treatment, the area under the curve (AUC) of rPHE, serum MMP-9 and NSE predicting the prognosis of patients were all>0.7. Among them, the AUC predicted by serum NSE was the largest, which was 0.822. When the cut-off value was 20.38 μg/L, the prediction sensitivity and specificity were 76.67% and 83.33%, respectively. Conclusion: RPHE, serum MMP-9, NSE are significantly related to the curative effect of basal ganglia intracerebral hemorrhage with lateral fissure approach, and early postoperative indicators have good application value in predicting the prognosis of patients.

Key words： Basal ganglia intracerebral hemorrhage Lateral fissure approach surgery Edema volume Matrix metalloproteinase-9 Neuron-specific enolase

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	WANG Haibo
	YOU Wenliang

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WANG Haibo,YOU Wenliang. The Relationship Between the Volume of Edema MMP-9 NSE and the Surgical Effect of Lateral Fissure Approach of Basal Ganglia Intracerebral Hemorrhage and Its Prognostic Value[J]. HeBei Med, 2021, 27(9): 1444-1449.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.09.009 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I9/1444

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