From the Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China (C.-Y.D., D.-Z.K., Y.-X.L., C.-Z.J., L.-H.Y., D.-L.W., Z.-Y.L.).
Department of Neurosurgery, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, People's Republic of China (Z.-L.W., J.-J.G.).
Stroke. 2019 Jul;50(7):1887-1890. doi: 10.1161/STROKEAHA.119.025733. Epub 2019 Jun 11.
Background and Purpose- Hypoxic-ischemic brain damage is a well-recognized physiopathologic mechanism after aneurysmal subarachnoid hemorrhage (aSAH). The Ngb (neuroglobin) is a hemoprotein predominantly expressed in the brain with a high affinity for oxygen. Relationship between serum Ngb level and brain metabolism in aSAH patients has not been investigated previously. Methods- Thirty-six consecutive severe aSAH patients (Glasgow Coma Scale score ≤8 on admission) with multimodal neuromonitoring and 36 matched healthy subjects were included. Serum Ngb level was analyzed in combination with other time-matched cerebral microdialysis parameters, brain tissue oxygen tension, and 12-month neurological outcomes. Results- Serum Ngb level was correlated positively with cerebral microdialysis parameters and brain tissue oxygen tension ( P<0.001). Poor functional outcome (modified Rankin Scale score >3) 12 months after aSAH was associated with higher Ngb level but independent of age, sex, and disease severity ( P<0.001). A similar association was found between high Ngb level and neuropsychological test results indicative of impairments in cognition, visual conceptualization, and frontal executive functions ( P<0.001). Conclusions- Ngb may be a potential biomarker for reflecting brain tissue oxygen tension, brain metabolism, and functional outcome in severe aSAH patients and merits further study in the context of aSAH.
背景与目的- 缺氧缺血性脑损伤是蛛网膜下腔出血（aSAH）后公认的病理生理机制。Ngb（神经球蛋白）是一种主要在大脑中表达的血红素蛋白，对氧气具有高亲和力。以前尚未研究过 aSAH 患者血清 Ngb 水平与脑代谢之间的关系。方法- 纳入 36 例连续的严重 aSAH 患者（入院时格拉斯哥昏迷量表评分≤8），并进行多模式神经监测，以及 36 例匹配的健康对照者。分析血清 Ngb 水平与其他时间匹配的脑微透析参数、脑组织氧张力以及 12 个月神经功能结局之间的关系。结果- 血清 Ngb 水平与脑微透析参数和脑组织氧张力呈正相关（P<0.001）。aSAH 后 12 个月功能结局不良（改良Rankin 量表评分>3）与较高的 Ngb 水平相关，但与年龄、性别和疾病严重程度无关（P<0.001）。高 Ngb 水平与神经心理学测试结果之间也存在类似的关联，这些测试结果表明认知、视觉概念化和额叶执行功能受损（P<0.001）。结论- Ngb 可能是反映严重 aSAH 患者脑组织氧张力、脑代谢和功能结局的潜在生物标志物，值得在 aSAH 背景下进一步研究。
