Pan De-Sheng, Yan Min, Hassan Muhammad, Fang Ze-Bin, Chen Man-Tao
Department of Neurosurgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China.
Department of Neurosurgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China.
J Neurol Sci. 2016 Mar 15;362:53-8. doi: 10.1016/j.jns.2016.01.024. Epub 2016 Jan 16.
CXC chemokine ligand-12 (CXCL12) is involved in the innate immune system. Elevation of its level in the peripheral blood is associated with severity and outcome of ischemic stroke. This study aimed to investigate its relation to severity and prognosis following aneurysmal subarachnoid hemorrhage (aSAH).
Serum CXCL12 levels were determined in a total of 182 controls and 182 aSAH patients. Hemorrhagic severity was assessed using the World Federation of Neurological Surgeons (WFNS) scale and modified Fisher grading scale. Unfavorable outcome was defined as Glasgow outcome scale score of 1-3. Prognostic predictors of 6-month mortality and unfavorable outcome were identified using multivariate analysis.
The serum CXCL12 levels were significantly higher in patients as compared to controls (14.5±6.7ng/mL vs. 1.7±0.6ng/mL, P<0.001) and were independently associated with WFNS scores (t=5.927, P<0.001) and modified Fisher scores (t=5.506, P<0.001). Serum CXCL12 levels predicted 6-month mortality and 6-month unfavorable outcome with the area under curves of 0.815 [95% confidence (CI), 0.751-0.868] and 0.809 (95% CI, 0.745-0.864) respectively and were related independently to 6-month mortality (odds ratio, 4.428; 95% CI, 1.977-12.031; P=0.004) and 6-month unfavorable outcome (odds ratio, 3.821; 95% CI, 1.097-9.251; P=0.001). Moreover, the predictive values of CXCL12 levels were in the range of WFNS scores and modified Fisher scores.
Elevation of serum CXCL12 levels is associated highly with hemorrhagic severity and poor outcome after aSAH, suggesting CXCL12 might have the potential to be a prognostic predictive biomarker of aSAH.
CXC趋化因子配体12（CXCL12）参与先天性免疫系统。其外周血水平升高与缺血性卒中的严重程度及预后相关。本研究旨在探讨其与动脉瘤性蛛网膜下腔出血（aSAH）严重程度及预后的关系。
共测定了182例对照者和182例aSAH患者的血清CXCL12水平。采用世界神经外科医师联合会（WFNS）量表和改良Fisher分级量表评估出血严重程度。不良预后定义为格拉斯哥预后量表评分为1 - 3分。采用多因素分析确定6个月死亡率和不良预后的预测指标。
与对照组相比，患者血清CXCL12水平显著升高（14.5±6.7ng/mL对1.7±0.6ng/mL，P<0.001），且与WFNS评分（t = 5.927，P<0.001）和改良Fisher评分（t = 5.506，P<0.001）独立相关。血清CXCL12水平预测6个月死亡率和6个月不良预后的曲线下面积分别为0.815[95%置信区间（CI），0.751 - 0.868]和0.809（95%CI，0.745 - 0.864），且与6个月死亡率（比值比，4.428；95%CI，1.977 - 12.031；P = 0.004）和6个月不良预后（比值比，3.821；95%CI，1.097 - 9.251；P = 0.001）独立相关。此外，CXCL12水平的预测价值在WFNS评分和改良Fisher评分范围内。
血清CXCL12水平升高与aSAH后的出血严重程度及不良预后高度相关，提示CXCL12可能有潜力成为aSAH的预后预测生物标志物。
