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比较脑动脉瘤性蛛网膜下腔出血患者的血浆copeptin 和多种生物标志物评估预后。

Comparison of plasma copeptin and multiple biomarkers for assessing prognosis of patients with aneurysmal subarachnoid hemorrhage.

机构信息

Department of Intensive Care Unit, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China.

Department of Neurosurgery, The Hangzhou First People's Hospital, Nanjing Medical University, 261 Huansha Road, Hangzhou 310006, China.

出版信息

Clin Chim Acta. 2017 Dec;475:64-69. doi: 10.1016/j.cca.2017.10.009. Epub 2017 Oct 13.

Abstract

BACKGROUND

Increased plasma copeptin concentrations are related to poor prognosis after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to assess prognostic significance of plasma copeptin detection compared with glial fibrillary astrocyte protein, myelin basic protein, S100B, phosphorylated axonal neurofilament subunit H, neuron-specific enolase, tau and ubiquitin carboxyl-terminal hydrolase L1 in aSAH.

METHODS

We detected plasma concentrations of the aforementioned biomarkers in 105 healthy controls using ELISA. Their predictive ability for symptomatic cerebral vasospasm and 6-month poor outcome (Glasgow Outcome Scale score of 1-3) were compared.

RESULTS

Plasma concentrations of the preceding biomarkers were highly correlated with World Federation of Neurological Surgeons subarachnoid hemorrhage scale (WFNS) scores as well as were significantly higher in patients with symptomatic cerebral vasospasm than in those without symptomatic cerebral vasospasm and in patients with poor outcome than in those with good outcome. In terms of area under receiver operating characteristic curve, their predictive value for symptomatic cerebral vasospasm and 6-month poor outcome was in the range of WFNS scores. Plasma copeptin concentration, but not plasma concentrations of other biomarkers, statistically significantly improved the predictive performance of WFNS scores.

CONCLUSIONS

Copeptin in plasma might have the potential to be a useful prognostic biomarker for aSAH.

摘要

背景

蛛网膜下腔出血(aSAH)后,血浆 copeptin 浓度升高与预后不良相关。本研究旨在评估与 GFAP、MBP、S100B、磷酸化轴突神经丝亚单位 H、神经元特异性烯醇化酶、tau 和泛素羧基末端水解酶 L1 相比,血浆 copeptin 检测对 aSAH 的预后意义。

方法

我们使用 ELISA 检测了 105 名健康对照者的上述生物标志物的血浆浓度。比较了它们对症状性脑血管痉挛和 6 个月不良结局(格拉斯哥预后评分 1-3)的预测能力。

结果

先前的生物标志物的血浆浓度与世界神经外科学联合会(WFNS)蛛网膜下腔出血分级高度相关,且在有症状性脑血管痉挛的患者中明显高于无症状性脑血管痉挛的患者,在不良结局的患者中明显高于结局良好的患者。在受试者工作特征曲线下面积方面,它们对症状性脑血管痉挛和 6 个月不良结局的预测价值与 WFNS 评分相当。与其他生物标志物相比,血浆 copeptin 浓度而非血浆浓度,统计学上显著提高了 WFNS 评分的预测性能。

结论

血浆 copeptin 可能有潜力成为 aSAH 的有用预后生物标志物。

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