Hirashima Y, Endo S, Nakamura S, Kurimoto M, Takaku A
Department of Neurosurgery, Toyama Medical and Pharmaceutical University, Sugitani, Japan.
Neurol Res. 2001 Oct;23(7):715-20. doi: 10.1179/016164101101199225.
No marker that predicts accurately the time of occurrence of cerebral vasospasm due to subarachnoid hemorrhage (SAH) has been reported. In the present study, membrane-bound tissue factor (mTF) and myelin basic protein (MBP) concentrations in cerebrospinal fluid (CSF) were evaluated as a predictor of the time of occurrence of cerebral vasospasm. The mTF and MBP concentrations were measured in the CSF from 28 patients with SAH due to ruptured aneurysm. Serial assays were performed from day 4 to day 14 after SAH. CSF mTF and MBP concentrations from days 5 to 9 correlated with the volume of cerebral infarction due to vasospasm and outcome three months after SAH. From the serial assays, CSF mTF measurements predicted the time of occurrence and severity and irreversibility of symptoms due to vasospasm. In conclusion, CSF mTF is predictive of the occurrence and the recovery of cerebral vasospasm, while CSF MBP is only an indicator of severity of brain damage due to vasospasm.
尚无能够准确预测蛛网膜下腔出血（SAH）所致脑血管痉挛发生时间的标志物报道。在本研究中，对脑脊液（CSF）中膜结合组织因子（mTF）和髓鞘碱性蛋白（MBP）浓度进行评估，以作为脑血管痉挛发生时间的预测指标。测定了28例因动脉瘤破裂导致SAH患者的脑脊液中mTF和MBP浓度。在SAH后第4天至第14天进行连续检测。SAH后第5天至第9天的脑脊液mTF和MBP浓度与因血管痉挛导致的脑梗死体积以及SAH后三个月的预后相关。通过连续检测，脑脊液mTF测量可预测血管痉挛所致症状的发生时间、严重程度和不可逆性。总之，脑脊液mTF可预测脑血管痉挛的发生和恢复，而脑脊液MBP仅是血管痉挛所致脑损伤严重程度的一个指标。
