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蛛网膜下腔出血后早期脑脊液中可溶性血小板衍生生长因子受体 β 的升高与脑血管痉挛相关。

The rise of soluble platelet-derived growth factor receptor β in CSF early after subarachnoid hemorrhage correlates with cerebral vasospasm.

机构信息

Department of Neurosurgery, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China.

Department of Neurosurgery, Jinling Hospital, School of Medicine, Southern Medical University (Guangzhou), 305 East Zhongshan Road, Nanjing, 210002, Jiangsu, People's Republic of China.

出版信息

Neurol Sci. 2018 Jun;39(6):1105-1111. doi: 10.1007/s10072-018-3329-y. Epub 2018 Apr 10.

Abstract

Platelet-derived growth factor β (PDGFβ) has been proposed to contribute to the development of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH), and soluble PDGFRβ (sPDGFRβ) is considered to be an inhibitor of PDGF signaling. We aimed at determining the sPDGFRβ concentrations in the cerebrospinal fluid (CSF) of patients with aneurysmal SAH (aSAH) and analyzing the relationship between sPDGFRβ level and CVS. CSF was sampled from 32 patients who suffered aSAH and five normal controls. Enzyme-linked immunosorbent assay was performed to determine the sPDGFRβ concentrations in the CSF. Functional outcome was assessed using modified Rankin scale (mRS) at 6 months after aSAH. CVS was identified using transcranial Doppler or angio-CT or DSA. The cutoff of sPDGFRβ for CVS was defined on the ROC curve. The concentrations of sPDGFRβ following aSAH were both higher than those of normal controls on days 1-3 and 4-6, and peaked on days 7-9 post-SAH. The cutoff value of sPDGFRβ level on days 1-3 for CVS was defined as 975.38 pg/ml according to the ROC curve (AUC = 0.680, p = 0.082). In addition, CSF sPDGFRβ concentrations correlated with CVS (r = 0.416, p = 0.018), and multivariate analysis indicated that sPDGFRβ level higher than 975.38 pg/ml on days 1-3 was an independent predictor of CVS (p = 0.001, OR = 19.22, 95% CI: 3.27-113.03), but not for unfavorable outcome after aSAH in the current study. CSF sPDGFRβ level increases after aSAH and is higher in patients who developed CVS, and sPDGFRβ level higher than 975.38 pg/ml on days 1-3 is a potential predictor for CVS after SAH.

摘要

血小板衍生生长因子 β(PDGFβ)被认为有助于蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)的发展,而可溶性 PDGFRβ(sPDGFRβ)被认为是 PDGF 信号的抑制剂。我们旨在确定患有动脉瘤性蛛网膜下腔出血(aSAH)患者的脑脊液(CSF)中的 sPDGFRβ 浓度,并分析 sPDGFRβ 水平与 CVS 之间的关系。从 32 名患有 aSAH 的患者和 5 名正常对照中采集 CSF。通过酶联免疫吸附测定法测定 CSF 中的 sPDGFRβ 浓度。使用改良 Rankin 量表(mRS)在 aSAH 后 6 个月评估功能预后。通过经颅多普勒或血管造影 CT 或 DSA 确定 CVS。根据 ROC 曲线定义 sPDGFRβ 用于 CVS 的截断值。aSAH 后第 1-3 天和第 4-6 天 CSF 中 sPDGFRβ 的浓度均高于正常对照组,且在 aSAH 后第 7-9 天达到峰值。根据 ROC 曲线(AUC=0.680,p=0.082),将第 1-3 天 sPDGFRβ 水平的截断值定义为 CVS 975.38pg/ml。此外,CSF sPDGFRβ 浓度与 CVS 相关(r=0.416,p=0.018),多变量分析表明,第 1-3 天 sPDGFRβ 水平高于 975.38pg/ml 是 CVS 的独立预测因子(p=0.001,OR=19.22,95%CI:3.27-113.03),但在本研究中,aSAH 后不良结局不是如此。aSAH 后 CSF sPDGFRβ 水平升高,发生 CVS 的患者水平更高,第 1-3 天 sPDGFRβ 水平高于 975.38pg/ml 是 aSAH 后 CVS 的潜在预测因子。

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