Serum HIF-1α and E-cadherin expression levels in patients with aneurysmal subarachnoid hemorrhage and their correlation with prognosis of interventional therapy

MAI Haojian; ZHANG Li; LI Huaxiao; LIU Yuhao; ZHANG Meng

Abstract：Objective To explore the relationship between serum hypoxia-inducing factor-1α (HIF-1α) and E-cadherin expression levels and prognosis after interventional therapy in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods A total of 150 patients with aSAH who received interventional therapy in our hospital from January 2019 to December 2023 were selected as the study objects. After 90 days of follow-up,the modified Rankin Scale (mRS) score was used to evaluate the prognosis of patients after interventional therapy,and good prognosis group (mRS Score 0-2,n=94) and poor prognosis group (mRS Score 3-6,n=56) were set up. Clinical data and serum HIF-1α and E-cadherin expression levels before treatment were collected from all of the enrolled patients. The efficacy of serum HIF-1α and E-cadherin in evaluating the prognosis of patients with aSAH after interventional therapy was evaluated by ROC,and the influencing factors of prognosis of patients with aSAH after interventional therapy were explored by binary Logistic step-up regression. Results The serum HIF-1α level in poor prognosis group was higher than the good prognosis group,and the E-cadherin level was lower than the good prognosis group (P<0.05). The AUC (95％ CI) of serum HIF-1α and E-cadherin in evaluating the prognosis of aSAH cases after interventional therapy were 0.832 (0.787-0.877) and 0.769 (0.719-0.819),respectively. The combined AUC (95％CI) was 0.922 (0.877-0.967). The proportion of patients with cerebral vasospasm,modified Fisher's grade Ⅲ,Hunt Hess grade Ⅲ,history of hypertension,and GCS score in the poor prognosis group were higher than those in the good prognosis group (P<0.05). Multivariate analysis showed that cerebrovascular spasm (OR=2.050,95％CI:1.254-3.353),Hunt-Hess classification grade Ⅲ(OR=2.354,95％CI:1.346-4.115),serum HIF-1α≥127.33 pg/mL (OR=3.374,95％CI:1.659-6.859),serum E-cadherin ≤ 168.26 ng/mL (OR=2.954,95％CI:1.624-5.370) were the prognostic factors of aSAH patients after interventional therapy (P<0.05). Conclusions The expression levels of HIF-1α and E-cadherin in aSAH patients are closely related to the prognosis of interventional therapy,which can be used as an important reference for prognosis evaluation.