Kawano T, Yonekawa Y
Department of Neurosurgery, National Cardiovascular Center.
No Shinkei Geka. 1990 Feb;18(2):145-52.
Twenty-one patients were submitted to investigate serum complements (CH50, C3, C4) after aneurysmal subarachnoid hemorrhage during a 2 to 3-week period. As for the control, the same examination was carried out in patients with non-subarachnoid hemorrhage such as hypertensive intracerebral hemorrhage. There was no remarkable changes of serum complements in the control patients. Preoperative grading (Hunt & Hess) was well correlated with C4 level but not C3 level. Ce and C4 level of the patients without symptomatic vasospasm did not change markedly after subarachnoid hemorrhage during the investigation, while they decreased severely in patients with severe vasospasm and major neurological deficit. The patients with mild symptomatic vasospasm without major neurological deficit showed transient decrease of C3 and C4 level in the period of 5 to 10 days after subarachnoid hemorrhage. These data show that sequential determinations of serum complements (C3 and C4) level after subarachnoid hemorrhage is a useful method for the choice of therapy, and for the prognosis of aneurysmal patients after subarachnoid hemorrhage.
21例动脉瘤性蛛网膜下腔出血患者在2至3周内接受了血清补体（CH50、C3、C4）检测。作为对照，对非蛛网膜下腔出血患者如高血压性脑出血患者进行了同样的检查。对照患者的血清补体无明显变化。术前分级（Hunt & Hess）与C4水平密切相关，但与C3水平无关。在研究期间，无症状血管痉挛患者的C3和C4水平在蛛网膜下腔出血后无明显变化，而严重血管痉挛和严重神经功能缺损患者的C3和C4水平则严重下降。轻度症状性血管痉挛且无严重神经功能缺损的患者在蛛网膜下腔出血后5至10天内C3和C4水平出现短暂下降。这些数据表明，蛛网膜下腔出血后连续测定血清补体（C3和C4）水平是选择治疗方法以及判断蛛网膜下腔出血后动脉瘤患者预后的有用方法。
