血清Panx-1、Sestrin2水平与急性脑出血患者病情严重程度及预后的关系

doi:10.3969/j.issn.1006-5725.2026.11.004

Abstract

Abstract:

Objective To evaluate the association of serum pannexin-1 （Panx-1） and stress-induced protein 2 （Sestrin2） levels with neurological severity and 30-day functional outcome in patients with acute intracerebral hemorrhage （AICH）. Methods A prospective observational cohort study was conducted involving 208 consecutive adult patients diagnosed with spontaneous AICH admitted to our center between February 2023 and April 2024. Patients were stratified by baseline National Institutes of Health Stroke Scale （NIHSS） score into mild （n = 63）， moderate （n = 94）， and severe （n = 51） neurological deficit subgroups. Two hundred age- and sex-matched healthy volunteers served as controls. Serum Panx-1 and Sestrin2 concentrations were quantified using validated ELISA kits. Group comparisons were performed using one-way ANOVA with Tukey’s post hoc test （for ≥ 3 groups） or independent-samples t-test （for two-group comparisons）. Pearson correlation coefficients assessed linear associations between biomarker levels， NIHSS score， and Glasgow Coma Scale （GCS） score. Multivariable logistic regression-adjusted for age， sex， hematoma volume （measured on baseline CT）， GCS， NIHSS， ICU length of stay， and comorbidities （cerebral herniation， pulmonary infection， deep vein thrombosis） was used to identify independent predictors of poor 30-day functional outcome （defined as modified Rankin Scale score ≥ 4）. Receiver operating characteristic （ROC） curve analysis determined the discriminatory accuracy of Panx-1， Sestrin2， and their combination for predicting poor outcome. Results Compared to control group， the levels of Panx-1 and Sestrin2 were significantly higher in AICH group （P < 0.05）. The serum levels of Panx-1 and Sestrin2 in severe defect subgroup were higher than those in mild and moderate defect subgroup （P < 0.05）. The serum levels of Panx-1 and Sestrin2 were positively correlated with NIHSS score， and negatively correlated with GCS score. Panx-1， Sestrin2， hematoma volume， GCS score， NIHSS score， ICU length of stay， concurrent cerebral herniation， concurrent pulmonary infection， and concurrent deep vein thrombosis were risk factors for poor prognosis in patients with AICH. ROC curve showed that the AUC value of combined diagnosis of Panx-1 and Sestrin2 was significantly higher than that of single diagnosis of Panx-1 and Sestrin2. Conclusions Serum Panx-1 and Sestrin2 levels are robust， severity-dependent biomarkers in AICH， independently associated with baseline neurological impairment and 30-day functional prognosis. Their synergistic integration enhances prognostic stratification accuracy beyond conventional clinical and radiological parameters， supporting their potential utility as adjunctive tools for early risk assessment and personalized therapeutic decision-making.

Key words: acute intracerebral hemorrhage, pannexin-1, stress-induced protein 2, NIHSS score, prognosis

CLC Number:

R541.4

Peng LÜ,Di SHI,Shuchong SHAN,Jingcui QIN. Relationship between serum levels of Panx-1 and Sestrin2 and the severity and prognosis of patients with acute cerebral hemorrhage[J]. The Journal of Practical Medicine, 2026, 42(11): 1915-1922.

Figures/Tables 7

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References 28

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项目	对照组（n = 200）	AICH组（n = 208）	χ²/t值	P值
性别/例			0.588	0.443
男	103	115
女	97	93
年龄/岁	57.25 ± 10.13	58.34 ± 9.06	1.147	0.252
BMI/（kg/m²）	22.15 ± 1.67	22.43 ± 1.88	1.588	0.113
吸烟史/［例（%）］	37（18.50）	35（16.83）	0.196	0.658
酗酒史/［例（%）］	9（4.50）	11（5.29）	0.135	0.712
高血压史/［例（%）］	17（8.50）	179（86.06）	245.703	< 0.001
糖尿病史/［例（%）］	15（7.50）	18（8.65）	0.183	0.669
冠心病史/［例（%）］	11（5.50）	10（4.81）	0.101	0.752
Panx-1/（mg/mL）	2.03 ± 0.55	13.58 ± 3.72	44.278	< 0.001
Sestrin2/（ng/mL）	1.72 ± 0.41	15.77 ± 4.08	49.406	< 0.001

组别	例数	Panx-1/（mg/mL）	Sestrin2/（ng/mL）
轻度缺损亚组	63	9.67 ± 2.34	11.52 ± 3.19
中度缺损亚组	94	13.51 ± 3.25^*	15.81 ± 4.37^*
重度缺损亚组	51	18.55 ± 4.08^*#	20.95 ± 4.82^*#
F值		114.711	71.996
P值		< 0.001	< 0.001

项目	预后良好组（n = 141）	预后不良组（n = 67）	χ²/t值	P值
性别/例			0.779	0.378
男	75	40
女	66	27
年龄/岁	57.95 ± 9.87	59.19 ± 9.62	0.854	0.394
BMI/（kg/m²）	22.39 ± 1.71	22.52 ± 1.83	0.501	0.617
吸烟史/［例（%）］	24（17.02）	11（16.42）	0.012	0.913
酗酒史/［例（%）］	7（4.96）	4（5.97）	0.092	0.762
高血压史/［例（%）］	121（85.82）	58（86.57）	0.021	0.884
糖尿病史/［例（%）］	12（8.51）	6（8.96）	0.011	0.915
冠心病史/［例（%）］	8（5.67）	2（2.99）	0.727	0.397
收缩压/mmHg	152.74 ± 15.65	155.63 ± 14.91	1.263	0.208
舒张压/mmHg	92.03 ± 6.16	93.27 ± 6.83	1.309	0.192
白细胞计数/（×10⁹/L）	8.36 ± 2.07	8.82 ± 2.16	1.477	0.141
血红蛋白/（g/L）	142.66 ± 15.74	139.98 ± 11.83	1.367	0.174
血小板计数/（×10⁹/L）	251.87 ± 30.69	259.11 ± 35.32	1.513	0.132
出血部位/［例（%）］			0.907	0.635
基底节区	76（53.90）	32（47.76）
脑叶内	34（24.11）	20（29.85）
其他	31（21.99）	15（22.39）
血肿体积/mL	10.37 ± 2.44	25.42 ± 6.17	19.263	< 0.001
GCS评分/分	10.86 ± 3.02	5.14 ± 1.15	19.686	< 0.001
NIHSS评分/分	8.49 ± 2.16	17.06 ± 4.28	15.480	< 0.001
ICU住院时间/d	3.15 ± 0.87	7.02 ± 1.99	15.241	< 0.001
并发脑疝/［例（%）］	2（1.42）	5（7.46）	5.101	0.024
并发肺部感染/［例（%）］	11（7.80）	9（22.39）	8.836	0.003
并发深静脉血栓/［例（%）］	1（0.71）	4（5.97）	5.357	0.021
Panx-1/（mg/mL）	11.85 ± 3.02	17.23 ± 4.15	9.485	< 0.001
Sestrin2/（ng/mL）	14.23 ± 2.87	19.01 ± 3.99	8.785	< 0.001

指标	Panx-1		Sestrin2
指标	r值	P值	r值	P值
血肿体积	0.236	0.078	0.251	0.092
GCS评分	-0.457	0.012	-0.492	0.008
NIHSS评分	0.535	< 0.001	0.509	< 0.001

自变量	单因素分析			多因素分析
自变量	OR	95%CI	P值	OR	95%CI	P值
性别	1.696	0.881 ~ 3.263	0.114	-	-	-
年龄	1.893	0.841 ~ 4.261	0.123	-	-	-
BMI	1.361	0.597 ~ 3.099	0.463	-	-	-
吸烟史	1.430	0.428 ~ 3.258	0.394	-	-	-
酗酒史	1.597	0.701 ~ 3.637	0.265	-	-	-
高血压史	1.818	0.798 ~ 4.142	0.155	-	-	-
糖尿病史	1.231	0.655 ~ 2.314	0.518	-	-	-
冠心病史	1.125	0.585 ~ 2.165	0.724	-	-	-
收缩压	1.422	0.439 ~ 4.609	0.557	-	-	-
舒张压	2.121	0.654 ~ 6.876	0.210	-	-	-
白细胞计数	1.737	0.392 ~ 7.703	0.468	-	-	-
血红蛋白	1.293	0.307 ~ 5.450	0.726	-	-	-
血小板计数	1.224	0.430 ~ 3.486	0.705	-	-	-
出血部位	1.219	0.633 ~ 2.346	0.553	-	-	-
血肿体积	3.228	1.460 ~ 7.141	0.004	4.609	1.686 ~ 12.597	0.003
GCS评分	0.327	0.170 ~ 0.629	0.001	0.198	0.070 ~ 0.565	0.002
NIHSS评分	7.885	1.871 ~ 33.236	0.005	8.654	3.404 ~ 21.998	< 0.001
ICU住院时间	2.787	1.563 ~ 4.969	0.001	2.998	1.507 ~ 5.965	0.002
并发脑疝	6.001	1.546 ~ 23.297	0.010	6.373	1.642 ~ 24.737	0.007
并发肺部感染	6.821	1.187 ~ 39.186	0.031	7.389	1.795 ~ 30.421	0.006
并发深静脉血栓	8.215	1.999 ~ 33.756	0.003	8.602	1.959 ~ 37.781	0.004
Panx-1	7.708	1.679 ~ 29.834	0.008	8.012	3.049 ~ 21.058	< 0.001
Sestrin2	5.795	1.375 ~ 24.426	< 0.017	7.050	2.605 ~ 19.081	< 0.001

Relationship between serum levels of Panx-1 and Sestrin2 and the severity and prognosis of patients with acute cerebral hemorrhage

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因素	AUC（95%CI）	最佳截断值	敏感度/%	特异度/%	Youden指数
Panx-1	0.701（0.629 ~ 0.773）	14.87 mg/mL	71.64	74.05	0.457
Sestrin2	0.677（0.598 ~ 0.755）	17.31 ng/mL	70.15	78.01	0.482
Panx-1 + Sestrin2	0.865（0.815 ~ 0.914）	-	80.60	77.30	0.579

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