组织激肽释放酶：预测动脉瘤性蛛网膜下腔出血后迟发性脑缺血的潜在血清标志物。

Tissue kallikrein: A potential serum biomarker to predict delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage.

机构信息

Department of Neurosurgery, HwaMei Hospital, University of Chinese Academy of Sciences, 41 Northwest Street, Ningbo 315010, China.

Department of Clinical Laboratory, HwaMei Hospital, University of Chinese Academy of Sciences, 41 Northwest Street, Ningbo 315010, China.

出版信息

Clin Chim Acta. 2020 Mar;502:148-152. doi: 10.1016/j.cca.2019.12.014. Epub 2019 Dec 19.

DOI:10.1016/j.cca.2019.12.014

PMID:31866331

Abstract

BACKGROUND

Delayed cerebral ischemia (DCI) is a severe complication after aneurysmal subarachnoid hemorrhage (aSAH). Tissue kallikrein (TK), a subgroup of serine proteinases, is an important component of the kallikrein-kinin system. Exogenous TK attenuated cerebral vasospasm in a rabbit model of subarachnoid hemorrhage. We intended to discern association of serum TK levels with aSAH-related DCI.

METHODS

Serum TK levels were detected in a total of 92 aSAH patients and 92 healthy controls. A multivariate logistic regression model was configured to investigate relationship between TK levels and occurrence of DCI.

RESULTS

TK levels were substantially lower in aSAH patients than in controls. TK levels were strongly correlated with World Federation of Neurological Surgeons (WFNS) score and modified Fisher score. Serum TK, WFNS score and modified Fisher score retained as the three independent predictors for DCI. Under receiver operating characteristic curve, predictive capability of TK levels was in the range of WFNS score and modified Fisher score, as well as TK levels could remarkably improve predictive abilities of WFNS score and modified Fisher score.

CONCLUSIONS

Serum TK emerges as a potential biomarker for assessment of hemorrhagic severity and prediction of DCI following aSAH.

摘要

背景

迟发性脑缺血（DCI）是蛛网膜下腔出血（aSAH）后的严重并发症。组织激肽释放酶（TK）是丝氨酸蛋白酶的一个亚群，是激肽释放酶-激肽系统的重要组成部分。外源性 TK 可减轻蛛网膜下腔出血兔模型的脑血管痉挛。我们旨在探讨血清 TK 水平与 aSAH 相关 DCI 的关系。

方法

共检测了 92 例 aSAH 患者和 92 例健康对照者的血清 TK 水平。采用多变量逻辑回归模型探讨 TK 水平与 DCI 发生的关系。

结果

aSAH 患者的 TK 水平明显低于对照组。TK 水平与世界神经外科学联合会（WFNS）评分和改良 Fisher 评分密切相关。血清 TK、WFNS 评分和改良 Fisher 评分是 DCI 的三个独立预测因子。在受试者工作特征曲线下，TK 水平的预测能力与 WFNS 评分和改良 Fisher 评分相当，且 TK 水平可显著提高 WFNS 评分和改良 Fisher 评分的预测能力。