摘要:
目的::评估高血压脑出血外科手术后患者血栓素 B2( TXB2)、6-酮前列腺素-F1α(6-Keto-PGF1α)及其比值与预后的相关性。方法:收集2012年12月至2015年1月本院收治的120例高血压脑出血患者作为高血压脑出血组,选取同期20例高血压未合并脑出血患者为高血压非脑出血组,20例健康体检者为对照组。监测血浆TXB2、6-keto-PGF1α及其比值,采用GOS量表评估患者预后情况,分析术后患者血浆TXB2、6-Keto-PGF1α及其比值与预后的相关性。结果:3组术前血清TXB2、6-keto-PGF1α值及其比值比较,差异均有统计学意义(P<0.05)。与术前比较,高血压脑出血组术后12 h血浆TXB2、6-Keto-PGF1α及其比值明显降低,术后3 d稍有上升,术后1周明显下降( P<0.05)。 GOS评分预后不良者TXB2/6-Keto-PGF1α比值高于预后良好者;脑水肿程度越高、脑梗死病灶越大、Barthel 指数越高,患者TXB2/6-Keto-PGF1α比值越高;且术后再发脑出血者 TXB2/6-Keto-PGF1α比值高于未再出血者( P<0.05)。血浆TXB2、TXB2/6-Keto-PGF1α与高血压脑出血术预后呈负相关(r=-0.847,-0.809,P<0.05),血浆6-Keto-PGF1α水平与高血压脑出血术预后呈正相关( r=0.832,P<0.05)。结论:高血压脑出血术后患者血浆TXB2与6-Keto-PGF1α及其比值与预后存在明显相关性,动态监测患者血浆TXB2与6-Keto-PGF1α及其比值可为患者后续治疗提供参照。%Objective: To evaluate the correlations of plasma thromboxane B2 ( TXB2 ) , 6-keto prostaglandin-F1α ( 6-Keto-PGF1α) , their ratio with the prognosis of patients after surgical treatment for hypertensive cerebral hemorrhage. Methods: 120 patients with hypertensive cerebral hemorrhage admitted into our hospital between December 2012 and January 2015 were included in the hypertensive cerebral hemorrhage group ( group A) . A contemporary cohort of 20 hypertensive patients without cerebral hemorrhage and 20 healthy people were recruited as groups B and C. Levels of plasma TXB2 and 6-Keto-PGF1αand the ratio of TXB2 over 6-Keto-PGF1α were monitored. The prognosis of patients was evaluated by Glasgow ( GOS ) scale. The correlations among plasma TXB2, 6-Keto-PGF1α and their ratio and the prognosis of patients after operation for hypertensive cerebral hemorrhage were analyzed. Results: At baseline, there were significant differences in plasma TXB2, 6-Keto-PGF1α levels and their ratio among the three groups (P<0.05). In group A, the plasma TXB2, 6-Keto-PGF1α levels and their ratio were reduced from baseline at 12h post-surgery, slightly rose on day 3, but appeared remarkably declined at 1 week post-surgery ( P<0.05) . The ratio of TXB2 to 6-Keto-PGF1αwas higher in patients with poorer prognosis as determined by GOS scale, in patients with more severe brain edema, larger size of cerebral infarction, and greater Barthe1 index, and also in those with relapse of cerebral hemorrhage compared with those without ( all P<0.05) . There was a negative correlation among plasma TXB2, TXB2/6-Keto-PGF1α and post-surgical prognosis (r=-0.847and-0.809, both P<0.05), and a positive correlation between plasma 6-Keto-PGF1α and post-surgical prognosis (r=0.832, P<0.05). Conclusion: Plasma TXB2, 6-Keto-PGF1α and their ratio in patients after surgical treatment for hypertensive cerebral hemorrhage are significantly correlated with the prognosis of the patients. Dynamic monitoring of plasma TXB2, 6-Keto-PGF1αand their ratio in these patients can provide a reference for the subsequent treatment strategy.