Expression and significance of vWF, GMP-140 and ADAMTS13 in patients with aneurysmal subarachnoid hemorrhage.

OBJECTIVE

The aim of this study was to investigate the role of the von Willebrand factor (vWF) in patients with aneurysmal subarachnoid hemorrhage (aSAH), platelet membrane glycoprotein-140 (GMP-140). The aim is also to discover the expression and clinical significance of von Willebrand factor (vWF) cleaving protease (ADAMTS13).

PATIENTS AND METHODS

83 patients with aSAH were selected from January 2014 to December 2016. The patients were divided into cerebral vasospasm group (CVS group) (n = 37) and no convulsion group (non-CVS group) (n = 46); delayed cerebral ischemia group (DCI group) (n = 31) and non-delayed cerebral ischemia group (non-DCI group) (n = 52). Also, the different aneurysm diameter group included 43 patients in < 5 mm group, 29 patients in 5-10 mm group, 11 patients in > 10 mm group. The number of patients in the good prognosis group and the poor prognosis group were 49 and 34, respectively. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of vWF, GMP-140, and ADAMTS13 in plasma of aSAH patients, and the correlation between the indexes was analyzed.

RESULTS

The repeated measures analysis of variance showed that there was no significant difference in plasma vWF, GMP-140, and ADAMTS13 levels in each group of the aSAH patients (p < 0.05). The vWF level of the CVS group was higher than that of the non-CVS group on day 4 and day 10. The GMP-140 level of the CVS group was higher than that of the non-CVS group on day 1, day 4 and day 10. And the ADAMTS13 level was lower than that of the non-CVS group on day 1 and day 10. The difference was statistically significant (p < 0.05). The plasma vWF level of DCI group was higher than that of the non-DCI group on day 1 and day 4. The plasma GMP-140 level at day 4 was higher than that of the non-DCI group. The plasma ADAMTS13 level at day 1 was lower than that in the non-DCI group. The difference was significant (p < 0.05). The plasma vWF level in > 10 mm group was higher than that in < 5 mm group and 5-10 mm group at day 1 and day 4. The plasma vWF level in 5-10 mm group was higher than that in < 5 mm group at day 4. The plasma GMP-140 levels in > 10 mm group were higher than that in < 5 mm group and 5-10 mm group at day 1 and d ay 4. The plasma GMP-140 level in 5-10 mm group was higher than that in < 5 mm group at day 1. The plasma ADAMTS13 level in > 10 mm group was lower than that in < 5 mm group and 5-10 mm group on day 1. Moreover, the plasma ADAMTS13 level in 5-10 mm group was lower than that in < 5 mm group: p < 0.05. The plasma vWF level in the good prognosis group was lower than that in the poor prognosis group on day 4 and day 10. On day 1, day 4, and day 10, the level of GMP-140 was lower than that of the poor prognosis group. The ADAMTS13 level on day 1 and day 4 was higher than that in the poor prognosis group. The difference was statistically significant (p < 0.05). Pearson product moment correlation analysis showed that the plasma vWF level was positively correlated with GMP-140 at day 1 (r = 0.334, p < 0.05), negatively correlated with ADAMTS13 (r = -0.426, p < 0.05), and GMP-140 was negatively correlated with ADAMTS13 (r = -0.398, p < 0.05). At day 4, plasma vWF was positively correlated with GMP-140 (r = 0.278, p < 0.05), negatively correlated with ADAMTS13 (r = -0.311, p < 0.05), and GMP-140 was negatively correlated with ADAMTS13 (r = -0.235, p < 0.05). At day 10, there was no significant correlation between vWF, GMP-140, and ADAMTS13 (p > 0.05).

CONCLUSIONS

VWF, GMP-140, and ADAMTS13 were correlated with the diameters and prognoses of CVS, DCI, aneurysms. Combined detection can help to evaluate the condition of patients with aSAH, so as to provide a guide for clinical treatment and prognosis.