Department of Neuroscience, Laboratory of Inflammation and Nervous System Diseases, Mario Negri Institute for Pharmacological Research, via Giuseppe La Masa, 19, 20156 Milan, Italy.
Intensive Care Med. 2011 Feb;37(2):302-9. doi: 10.1007/s00134-010-2075-2. Epub 2010 Nov 12.
To investigate plasma and cerebrospinal fluid (CSF) concentrations of pentraxin 3 (PTX3), a prototypic long pentraxin protein induced by proinflammatory signals, in subarachnoid hemorrhage (SAH), and its relation with SAH-associated vasospasm.
Serial plasma and CSF samples were collected from 38 consecutive SAH patients admitted to the Neurosurgical Intensive Care. PTX3 concentrations were analyzed in relation to clinical status and clinical vasospasm (defined as neuro-worsening and angiographic confirmation of vessel narrowing). Since neutrophils are an important source of preformed PTX3, myeloperoxidase (MPO) in CSF was measured to assess the correlation with CSF PTX3 and establish whether blood contamination was the determinant of PTX3 increase.
PTX3 was elevated in all SAH patients both in plasma and CSF. Acute peak (first 48 h after SAH) CSF PTX3 was significantly higher in patients who later developed vasospasm [median 13.6 (range 2.3-51.9) ng/ml] compared to those who did not [3.2 (0.1-50.5) ng/ml, p = 0.03]. The temporal pattern of CSF PTX3 in patients with vasospasm was triphasic with a peak during the first 48 h after SAH, a subsequent decrease in the following 48-96 h and a secondary significant increase with the occurrence of vasospasm. A loose correlation between CSF PTX3 and MPO was observed (r(2) = 0.13), indicating that following SAH there is a brain production of PTX3.
Acute increased concentrations of PTX3 in CSF but not in plasma are related to the occurrence of vasospasm, indicating that measurement of CSF PTX3 associated with the clinical evaluation can improve early diagnosis of this complication.
研究原典型长型五聚素蛋白（PTX3）在蛛网膜下腔出血（SAH）患者中的血浆和脑脊液（CSF）浓度，以及其与 SAH 相关性血管痉挛的关系。
连续收集 38 例入住神经外科重症监护病房的 SAH 患者的血浆和 CSF 标本。分析 PTX3 浓度与临床状态和临床血管痉挛（定义为神经恶化和血管狭窄的血管造影证实）的关系。由于中性粒细胞是预形成 PTX3 的重要来源，因此测定 CSF 中的髓过氧化物酶（MPO）以评估其与 CSF-PTX3 的相关性，并确定血液污染是否是 PTX3 升高的决定因素。
所有 SAH 患者的血浆和 CSF 中均存在 PTX3 升高。在发生血管痉挛的患者中，急性高峰（SAH 后 48 小时内）CSF-PTX3 明显高于未发生血管痉挛的患者[中位数 13.6（范围 2.3-51.9）ng/ml 比 3.2（0.1-50.5）ng/ml，p = 0.03]。发生血管痉挛的患者 CSF-PTX3 的时间模式呈三相性，在 SAH 后 48 小时内出现高峰，随后在接下来的 48-96 小时内下降，在发生血管痉挛时出现第二次显著升高。CSF-PTX3 与 MPO 之间存在松散的相关性（r(2) = 0.13），表明在 SAH 后，大脑中存在 PTX3 的产生。
CSF 中急性增加的 PTX3 浓度而不是血浆与血管痉挛的发生有关，表明与临床评估相结合测量 CSF-PTX3 可以改善这种并发症的早期诊断。
