Lorente Leonardo, Martín María M, Abreu-González Pedro, Sabatel Rafael, Ramos Luis, Argueso Mónica, Solé-Violán Jordi, Riaño-Ruiz Marta, Jiménez Alejandro, García-Marín Victor
Intensive Care Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain.
World Neurosurg. 2018 May;113:e542-e547. doi: 10.1016/j.wneu.2018.02.085. Epub 2018 Feb 23.
Oxidative stress has been associated with secondary brain injury after spontaneous intracerebral hemorrhage (SIH). Malondialdehyde (MDA) appears in blood during lipid oxidation. Higher serum MDA levels have been found in patients with SIH than in healthy controls; however, we have not found data indicating an association between elevated serum MDA and early mortality in this population. This was the main objective of our study.
MDA levels were measured in serum samples obtained from 100 patients at diagnosis of severe SIH (Glasgow Coma Scale score ≤8) and 80 healthy controls. The endpoint of the study was mortality at 30 days.
Serum MDA levels were significantly higher in patients with severe SIH than in healthy controls (1.46 [1.18-2.2] vs. 1.11 [0.72-1.51]; P < 0.001), and in nonsurviving (n = 46) than in surviving (n = 54) patients (1.68 [1.23-4.02] vs. 1.37 [0.99-1.92]; P = 0.002). The area under the receiving operating characteristic curve of serum MDA levels to predict 30-day mortality was 0.68 (95% CI, 0.58-0.77; P < 0.001). Serum MDA levels were associated with 30-day mortality (OR, 6.279; 95% CI, 1.940-20.319; P = 0.002).
The most important new finding of our study is that there is an association between serum MDA levels at diagnosis of severe SIH and early mortality.
氧化应激与自发性脑出血（SIH）后的继发性脑损伤有关。丙二醛（MDA）在脂质氧化过程中出现在血液中。已发现SIH患者的血清MDA水平高于健康对照者；然而，我们尚未找到表明该人群血清MDA升高与早期死亡率之间存在关联的数据。这是我们研究的主要目的。
在确诊为严重SIH（格拉斯哥昏迷量表评分≤8）的100例患者和80例健康对照者的血清样本中测量MDA水平。研究的终点是30天死亡率。
严重SIH患者的血清MDA水平显著高于健康对照者（1.46[1.18 - 2.2]对1.11[0.72 - 1.51]；P < 0.001），且未存活患者（n = 46）高于存活患者（n = 54）（1.68[1.23 - 4.02]对1.37[0.99 - 1.92]；P = 0.002）。血清MDA水平预测30天死亡率的受试者工作特征曲线下面积为0.68（95%CI，0.58 - 0.77；P < 0.001）。血清MDA水平与30天死亡率相关（OR，6.279；95%CI，1.940 - 20.319；P = 0.002）。
我们研究最重要的新发现是，严重SIH诊断时的血清MDA水平与早期死亡率之间存在关联。
