Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
Thromb Res. 2015 Jul;136(1):24-9. doi: 10.1016/j.thromres.2015.03.025. Epub 2015 Apr 9.
Increased circulating soluble CD40 ligand (sCD40L) levels have been reported to be associated with severity and mortality of severe traumatic brain injury. The current study tested the hypothesis that elevated plasma sCD40L levels are predictive of clinical outcomes of aneurysmal subarachnoid hemorrhage (aSAH).
Plasma sCD40L concentrations of 120 aSAH patients and 120 healthy volunteers were measured using enzyme-linked immunosorbent assay. An unfavorable outcome was defined as Glasgow Outcome Scale score of 1-3.
Plasma sCD40L levels were significantly elevated in aSAH patients compared with healthy controls; plasma sCD40L levels were highly associated with clinical severity reflected by World Federation of Neurological Surgeons (WFNS) score and Fisher score; sCD40L emerged as an independent predictor of 6-month mortality and unfavorable outcome and 6-month overall survival; although a combined logistic-regression model did not demonstrate the additive benefit of sCD40L to WFNS score and Fisher score, sCD40L possessed similar predictive value to WFNS score and Fisher score based on receiver operating characteristic curves.
Higher plasma sCD40L levels on presentation are associated with clinical severity and have potential to be a good prognostic biomarker of aSAH.
已有研究报道，循环可溶性 CD40 配体（sCD40L）水平升高与严重创伤性脑损伤的严重程度和死亡率相关。本研究旨在验证血浆 sCD40L 水平升高是否可预测颅内动脉瘤性蛛网膜下腔出血（aSAH）的临床结局这一假说。
采用酶联免疫吸附试验检测 120 例 aSAH 患者和 120 例健康志愿者的血浆 sCD40L 浓度。采用格拉斯哥预后量表（GOS）评分 1-3 定义预后不良。
与健康对照组相比，aSAH 患者的血浆 sCD40L 水平显著升高；血浆 sCD40L 水平与 WFNS 评分和 Fisher 评分所反映的临床严重程度高度相关；sCD40L 是 6 个月死亡率和预后不良以及 6 个月总生存率的独立预测因子；尽管联合逻辑回归模型并未显示 sCD40L 对 WFNS 评分和 Fisher 评分有额外的预测价值，但基于受试者工作特征曲线，sCD40L 对 WFNS 评分和 Fisher 评分具有相似的预测价值。
发病时较高的血浆 sCD40L 水平与临床严重程度相关，可能成为 aSAH 的良好预后生物标志物。
