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D-二聚体可能预测动脉瘤性蛛网膜下腔出血患者的不良预后:一项回顾性研究。

D-dimer may predict poor outcomes in patients with aneurysmal subarachnoid hemorrhage: a retrospective study.

作者信息

Liu Jun-Hui, Li Xiang-Kui, Chen Zhi-Biao, Cai Qiang, Wang Long, Ye Ying-Hu, Chen Qian-Xue

机构信息

Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.

Department of Neurosurgery, Affiliated Hospital of Shandong Medical College, Linyi, Shandong Province, China.

出版信息

Neural Regen Res. 2017 Dec;12(12):2014-2020. doi: 10.4103/1673-5374.221158.

Abstract

Serum biomarkers may play a reliable role in predicting the outcomes of patients with aneurysmal subarachnoid hemorrhage. This study retrospectively analyzed the relationship between serum biomarkers on admission and outcomes in patients with aneurysmal subarachnoid hemorrhage. We recruited 146 patients with aneurysmal subarachnoid hemorrhage who were treated in Renmin Hospital of Wuhan University of China between 1 May 2014 and 30 March 2016. There were 57 males and 89 females included and average age of included patients was 57.03 years old. Serum samples were taken immediately on admission (within 48 hours after initial hemorrhage) and the levels of serum biomarkers were detected. Baseline information, complications, and outcomes at 6 months were recorded. Univariate and multivariate logistic regression analyses were used to explore the relationship between biomarkers and clinical outcomes. Receiver operating characteristic curves were obtained to investigate the possibility of the biomarkers predicting prognosis. Of the 146 patients, 102 patients achieved good outcomes and 44 patients had poor outcomes. Univariate and multivariate analyses showed that high World Federation of Neurosurgical Societies grade, high serum D-dimer levels, and high neurological complications were significantly associated with poor outcomes. Receiver operating characteristic curves verified that D-dimer levels were associated with poor outcomes. D-dimer levels strongly correlated with neurological complications. In conclusion, we suggest that D-dimer levels are a good independent prognostic factor for poor outcomes in patients with aneurysmal subarachnoid hemorrhage.

摘要

血清生物标志物在预测动脉瘤性蛛网膜下腔出血患者的预后方面可能发挥可靠作用。本研究回顾性分析了动脉瘤性蛛网膜下腔出血患者入院时血清生物标志物与预后之间的关系。我们纳入了2014年5月1日至2016年3月30日在中国武汉大学人民医院接受治疗的146例动脉瘤性蛛网膜下腔出血患者。其中男性57例,女性89例,纳入患者的平均年龄为57.03岁。入院时(初次出血后48小时内)立即采集血清样本,并检测血清生物标志物水平。记录基线信息、并发症以及6个月时的预后情况。采用单因素和多因素逻辑回归分析来探讨生物标志物与临床预后之间的关系。绘制受试者工作特征曲线以研究生物标志物预测预后的可能性。在这146例患者中,102例患者预后良好,44例患者预后不良。单因素和多因素分析表明,世界神经外科联盟分级高、血清D-二聚体水平高以及神经并发症多与预后不良显著相关。受试者工作特征曲线证实D-二聚体水平与预后不良有关。D-二聚体水平与神经并发症密切相关。总之,我们认为D-二聚体水平是动脉瘤性蛛网膜下腔出血患者预后不良的一个良好独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5212/5784349/89d2d1555825/NRR-12-2014-g006.jpg

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