PDF(Pubmed)
Abstract：
OBJECTIVE: Secretoneurin may play a brain-protective role. We aim to discover the relationship between serum secretoneurin levels and severity plus neurological outcome after intracerebral hemorrhage (ICH).
METHODS: In this prospective cohort study, serum secretoneurin levels were measured in 110 ICH patients and 110 healthy controls. Glasgow Coma Scale (GCS) and hematoma volume were used to assess stroke severity. Poor prognosis was defined as Glasgow Outcome Scale (GOS) scores of 1-3 at 90 days after ICH. A multivariate logistic regression model was constructed to determine independent correlation of serum secretoneurin levels with severity and poor prognosis. Under receiver operating characteristic (ROC) curve, prognostic ability of serum secretoneurin levels was assessed. Restricted cubic spline (RCS) model and subgroups analysis were used for discovering association of serum secretoneurin levels with risk of poor prognosis. Calibration curve and decision curve were evaluated to confirm performance of nomogram.
RESULTS: Serum secretoneurin levels of patients were significantly higher than those of healthy controls. Serum secretoneurin levels of patients were independently correlated with GCS scores and hematoma volume. There were 42 patients with poor prognosis at 90 days following ICH. Serum secretoneurin levels were significantly higher in patients with poor outcome than in those with good outcome. Under the ROC curve, serum secretoneurin levels significantly differentiated poor outcome. Serum secretoneurin levels ≥ 22.8 ng/mL distinguished patients at risk of poor prognosis at 90 days with a sensitivity of 66.2% and a specificity of 81.0%. Besides, serum secretoneurin levels independently predicted a 90-day poor prognosis. Subgroup analysis showed that serum secretoneurin levels had non-significant interactions with other variables. The nomogram, including independent prognostic predictors, showed reliable prognosis capability using calibration curve and decision curve. Area under the curve of the predictive model was significantly higher than those of GCS scores and hematoma volume.
CONCLUSIONS: Serum secretoneurin levels are strongly related to ICH severity and poor prognosis at 90 days after ICH. Thus, serum secretoneurin may be a promising prognostic biomarker in ICH.
METHODS: In this prospective cohort study, serum secretoneurin levels were measured in 110 ICH patients and 110 healthy controls. Glasgow Coma Scale (GCS) and hematoma volume were used to assess stroke severity. Poor prognosis was defined as Glasgow Outcome Scale (GOS) scores of 1-3 at 90 days after ICH. A multivariate logistic regression model was constructed to determine independent correlation of serum secretoneurin levels with severity and poor prognosis. Under receiver operating characteristic (ROC) curve, prognostic ability of serum secretoneurin levels was assessed. Restricted cubic spline (RCS) model and subgroups analysis were used for discovering association of serum secretoneurin levels with risk of poor prognosis. Calibration curve and decision curve were evaluated to confirm performance of nomogram.
RESULTS: Serum secretoneurin levels of patients were significantly higher than those of healthy controls. Serum secretoneurin levels of patients were independently correlated with GCS scores and hematoma volume. There were 42 patients with poor prognosis at 90 days following ICH. Serum secretoneurin levels were significantly higher in patients with poor outcome than in those with good outcome. Under the ROC curve, serum secretoneurin levels significantly differentiated poor outcome. Serum secretoneurin levels ≥ 22.8 ng/mL distinguished patients at risk of poor prognosis at 90 days with a sensitivity of 66.2% and a specificity of 81.0%. Besides, serum secretoneurin levels independently predicted a 90-day poor prognosis. Subgroup analysis showed that serum secretoneurin levels had non-significant interactions with other variables. The nomogram, including independent prognostic predictors, showed reliable prognosis capability using calibration curve and decision curve. Area under the curve of the predictive model was significantly higher than those of GCS scores and hematoma volume.
CONCLUSIONS: Serum secretoneurin levels are strongly related to ICH severity and poor prognosis at 90 days after ICH. Thus, serum secretoneurin may be a promising prognostic biomarker in ICH.
摘要：
目的：神经分泌素可能具有脑保护作用。我们的目的是发现脑出血（ICH）后血清分泌神经元蛋白水平与严重程度和神经系统预后之间的关系。
方法：在这项前瞻性队列研究中，在110例ICH患者和110例健康对照者中测定了血清分泌神经元蛋白水平.采用格拉斯哥昏迷量表（GCS）和血肿量评估卒中严重程度。预后不良定义为ICH后90天的格拉斯哥预后量表（GOS）评分为1-3分。建立多因素logistic回归模型以确定血清分泌神经元素水平与严重程度和不良预后的独立相关性。在接收器工作特性(ROC)曲线下，评估血清分泌神经元蛋白水平的预后能力。限制性三次样条（RCS）模型和亚组分析用于发现血清分泌素水平与不良预后风险的关联。评价校准曲线和判定曲线以确认列线图的性能。
结果：患者血清分泌神经元素水平明显高于健康对照组。患者血清分泌神经元蛋白水平与GCS评分和血肿体积独立相关。有42例患者在ICH后90天预后不良。预后不良的患者的血清分泌神经元蛋白水平明显高于预后良好的患者。在ROC曲线下,血清分泌神经元蛋白水平显着区分不良结局。血清分泌神经元素水平≥22.8ng/mL的患者在90天有预后不良的风险，敏感性为66.2％，特异性为81.0％。此外,血清分泌神经元蛋白水平独立预测90天预后不良。亚组分析显示血清分泌神经元素水平与其他变量无显著交互作用。列线图，包括独立的预后预测因子，使用校准曲线和决策曲线显示出可靠的预后能力。预测模型的曲线下面积明显高于GCS评分和血肿体积。
结论：血清分泌神经元蛋白水平与ICH后90天的ICH严重程度和不良预后密切相关。因此，血清分泌神经元蛋白可能是ICH中一个有前景的预后生物标志物.
方法：在这项前瞻性队列研究中，在110例ICH患者和110例健康对照者中测定了血清分泌神经元蛋白水平.采用格拉斯哥昏迷量表（GCS）和血肿量评估卒中严重程度。预后不良定义为ICH后90天的格拉斯哥预后量表（GOS）评分为1-3分。建立多因素logistic回归模型以确定血清分泌神经元素水平与严重程度和不良预后的独立相关性。在接收器工作特性(ROC)曲线下，评估血清分泌神经元蛋白水平的预后能力。限制性三次样条（RCS）模型和亚组分析用于发现血清分泌素水平与不良预后风险的关联。评价校准曲线和判定曲线以确认列线图的性能。
结果：患者血清分泌神经元素水平明显高于健康对照组。患者血清分泌神经元蛋白水平与GCS评分和血肿体积独立相关。有42例患者在ICH后90天预后不良。预后不良的患者的血清分泌神经元蛋白水平明显高于预后良好的患者。在ROC曲线下,血清分泌神经元蛋白水平显着区分不良结局。血清分泌神经元素水平≥22.8ng/mL的患者在90天有预后不良的风险，敏感性为66.2％，特异性为81.0％。此外,血清分泌神经元蛋白水平独立预测90天预后不良。亚组分析显示血清分泌神经元素水平与其他变量无显著交互作用。列线图，包括独立的预后预测因子，使用校准曲线和决策曲线显示出可靠的预后能力。预测模型的曲线下面积明显高于GCS评分和血肿体积。
结论：血清分泌神经元蛋白水平与ICH后90天的ICH严重程度和不良预后密切相关。因此，血清分泌神经元蛋白可能是ICH中一个有前景的预后生物标志物.
