Fibulin-5: a novel biomarker for evaluating severity and predicting prognosis in patients with acute intracerebral haemorrhage
Fibulin-5: a novel biomarker for evaluating severity and predicting prognosis in patients with acute intracerebral haemorrhage
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Fibulin-5：一种用于评估急性脑出血患者严重程度和预测预后的新型生物标志物
DOI：
10.1111/ene.13013
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发表时间：
2016-07-01
影响因子：
5.1
通讯作者：
Qin, X. -Y.
中科院分区：
文献类型：
--
作者：
Hu, L.;Dong, M. -X.;Qin, X. -Y.
研究背景与目的探讨血清纤维蛋白-5（fibulin-5，FIB-5）水平与急性脑出血（acute intracerebral hemorrhage，ICH）患者病情严重程度及预后的关系。出血后3 d内入院时进行NIHSS评分和格拉斯哥昏迷评分（GCS）。计算脑出血量，同时测定血清fibulin-5浓度。采用多元线性回归分析确定血清fibulin-5浓度的危险因素，并获得斯皮尔曼相关系数，以探讨fibulin-5浓度与NIHSS或GCS评分之间的关系。术后随访3个月，采用改良兰金量表对所有存活者进行评分。采用受试者工作特征（ROC）曲线，探讨脑出血患者血清中fibulin-5浓度对预后的预测价值（65.86 26.39 g/l vs. 40.66 +/- 5.03 g/l，P = 0.00），主要受出血量影响（= 0.905，P = 0.000）和延伸至心室（= 10.173，P = 0.097）。血清fibulin-5浓度与NIHSS评分呈正相关（r = 0.511，P = 0.000），与GCS评分呈负相关（r =-0.585，P = 0.000）。根据ROC曲线，以80.68 g/l为死亡的最佳分界点，其敏感性和特异性分别为77.8%和93.2%，以48.45 g/l为预后不良的最佳分界点，其敏感性和特异性分别为86.4%和54.1%。结论血清fibulin-5浓度可作为评估脑出血患者病情严重程度和预测预后的生物标志物。
Background and purposeThe aim was to investigate relationships between serum fibulin-5 concentration and the severity or prognosis in patients with acute intracerebral haemorrhage (ICH).MethodsConsecutive ICH patients and healthy controls were included and clinical data were collected. National Institute of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS) were assessed at admission time within 3 days after bleeding. Cerebral haemorrhage volume was calculated and serum fibulin-5 concentration was measured at the same time. Multivariate linear regression analyses were performed to determine risk factors for serum fibulin-5 concentration and Spearman correlation coefficients were obtained to explore the relationships between fibulin-5 concentration and NIHSS or GCS scores. Patients were followed up for 3 months and the modified Rankin Scale was evaluated for all survivors. Receiver operating characteristic (ROC) curves were obtained to explore fibulin-5 concentration in predicting prognosis.ResultsSerum fibulin-5 concentration had increased in ICH patients compared with healthy controls (65.86 26.39 g/l vs. 40.66 +/- 5.03 g/l, P = 0.00) and was mainly influenced by haemorrhage volume ( = 0.905, P = 0.000) and extension to ventricles ( = 10.173, P = 0.097). Serum fibulin-5 concentration was positively correlated with NIHSS score (r = 0.511, P = 0.000) but inversely correlated with GCS score (r = -0.585, P = 0.000). Based on the ROC curves, the optimal cut-off point was 80.68 g/l for death, and the sensitivity and specificity values of serum fibulin-5 were 77.8% and 93.2%, whilst the optimal cut-off point was 48.45 g/l for poor prognosis and the sensitivity and specificity values were 86.4% and 54.1%, respectively.ConclusionsSerum fibulin-5 concentration can be regarded as a biomarker for evaluating disease severity and predicting prognosis in ICH patients.