关键词: 基质金属蛋白酶-9, 热休克蛋白47, 急性脑出血, 预后, ROC曲线

Abstract: Objective  To explore the correlation of serum matrix metalloproteinase-9 (MMP-9) and heat shock protein-47 (HSP-47) levels with prognosis in patients with acute cerebral hemorrhage.Methods  One hundred and forty-five patients with acute cerebral hemorrhage attending our hospital from March 2018 to May 2022 were selected,and assigned into good prognosis group (n=80) and poor prognosis group (n=65) according to their postoperative prognosis.General information of patients was recorded.The early morning of the day after admission fasting peripheral venous blood samples were collected for the detection of serum MMP-9 and HSP47 levels.Multivariate Logistic- regression analysis was conducted to screen the risk factors affecting poor prognosis in patients with acute cerebral hemorrhage,and the predictive value of serum MMP-9 and HSP47 levels on prognosis of patients with acute cerebral hemorrhage was evaluated by plotting ROC curve.Results Statistical difference was found in shape and volume of hematoma between two groups (P<0.05).Serum MMP-9 and HSP47 levels in poor prognosis group were higher than that in good prognosis group (P<0.05).Multivariate Logistic- regression analysis denoted that duration of surgery,hematoma shape,hematoma volume,serum MMP-9 and HSP47 levels were all risk factors for poor prognosis in patients with acute cerebral hemorrhage (P<0.05).Patients with the time of onset to surgery > 24 hours irregular shaped hematoma,large hematoma volume,and elevated serum levels of MMP-9 and HSP47 suffered a high risk of poor prognosis.ROC curve analysis demonstrated that AUC of serum MMP-9 and HSP47 levels for predicting the postoperative prognosis of patients with acute cerebral haemorrhage were 0.718 and 0.827,with a sensitivity of 81.5% and 80.0%,and a specificity of 50.0% and 81.2%,respectively.The AUC,sensitivity and specificity of combined detection of serum MMP-9 and HSP47 for prognosis prediction were 0.891,86.2% and 85.0%.Conclusion  Serum MMP9 and HSP47 levels are elevated in patients with poor prognosis after acute cerebral haemorrhage,and irregular shaped hematoma,hematoma volume,and serum MMP-9 and HSP47 levels are risk factors for poor prognosis after acute cerebral haemorrhage.Furthermore,serum MMP-9 and HSP47 are of great predictive value for the prognosis of patients with acute cerebral haemorrhage,and the predictive efficacy of combined detection of the two is better than that of separate test.

Key words: matrix metalloproteinase-9 , heat shock protein-47, acute cerebral hemorrhage, prognosis, ROC curve