Relationship between serological index expression and disease outcome in patients with acute intracerebral hemorrhage

Zhang Xiaoguang; Wang Hua; Liu Ziyu; Feng Yifan

doi:10.11850/j.issn.1009-122X.2024.11.005

Abstract：Objective To analyze the relationship between the levels of matrix metalloproteinase-9 (MMP-9),intercellular adhesion molecule-1 (ICAM-1),macrophage chemotactic protein-1α (MIP-1α),and central nervous system specific protein β (S-100β) in patients with acute intracerebral hemorrhage (AICH) and their disease progression and prognosis. Methods A total of 112 patients with AICH were included in the study group and classified into mild (GCS≥12,n=51),moderate (GCS 9-11,n=35),and severe (GCS≤8,n=26) groups based on the Glasgow Coma Scale (GCS). Additionally,115 healthy individuals during the same period were included as the control group. Follow-up was conducted for 6 months after treatment (with 3 cases lost to follow-up). The prognosis was evaluated using the Glasgow Outcome Score (GOS),dividing patients into a good prognosis group (GOS≥4,n=81) and a poor prognosis group (GOS<4,n=28). The serum levels of MMP-9,ICAM-1,MIP-1α,and S-100β were compared between the study group and control group,and between the patients with different severity levels and between the patients with different prognoses in the study group. Spearman correlation analysis was used to assess the correlation between these markers and disease progression. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of individual and combined detection of these markers for the prognosis of AICH patients. Results The serum levels of MMP-9,ICAM-1,MIP-1α,and S-100βwere higher in the study group than in the control group (all P<0.05). The levels of these markers showed an increasing trend in mild,moderate,and severe AICH groups (P<0.05). Spearman correlation analysis revealed a positive correlation between the levels of MMP-9,ICAM-1,MIP-1α and S-100 β and disease progression in AICH patients (P<0.05). The levels of these markers were higher in the poor prognosis group than in the good prognosis group (P<0.05). ROC curves were plotted to analyze the predictive value of individual and combined detection of MMP-9,ICAM-1,MIP-1αand S-100βfor AICH prognosis. The areas under the curve (AUC) were 0.746,0.727,0.772,0.646,and 0.892,respectively,with sensitivities of 64.29％,75.00％,67.86％,64.29％,and 85.71％,and specificities of 79.01％,64.20％,82.72％,69.14％,and 86.42％. Combined detection showed the highest AUC (Z=2.267,2.618,2.149,3.528,P<0.05). Conclusions Disease progression and poor prognosis in AICH patients are closely related to increased levels of MMP-9,ICAM-1,MIP-1α,and S-100β. Combined detection of these markers has a high predictive value for poor prognosis.