Wang Chenchen, Kou Yun, Han Yuwei, Li Xiaoming
Institute of Neurology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.
Special Medicine Departments, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.
J Stroke Cerebrovasc Dis. 2020 May;29(5):104770. doi: 10.1016/j.jstrokecerebrovasdis.2020.104770. Epub 2020 Mar 13.
To investigate the association of early serum calprotectin (S100A8/A9) level with disease severity and prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH).
Serum samples were collected from 54 patients with aSAH (within 48 hours of onset) and 54 health controls. Levels of serum calprotectin were determined by enzyme linked immunosorbent assay. The clinical data of aSAH patients were collected. The prognosis was evaluated by modified Rankin scale at 3 months. Univariate and multivariable logistic regression analysis, bivariate correlation analysis and receiver operating characteristic (ROC) curve analysis were used respectively.
Serum calprotectin levels were significantly higher in aSAH patients than that in healthy controls (P < .001). The clinical severity was also significantly correlated with the level of serum calprotectin. Patients with poor prognosis at 3 months showed higher serum calprotectin levels within 48 hours of onset than that in patients with good prognosis (P = .002). The level of serum calprotectin within 48 hours was related to the complications of secondary pneumonia. Serum calprotectin can be used as an independent predictor for delayed cerebral ischemia (DCI) after aSAH and poor prognosis in patients with aSAH at 3 months. The ROC curve showed the cutoff value of calprotectin for predicting poor prognosis at 3 months was 6020 pg/ml (sensitivity: 53.57%, specificity: 96.15%), and the cutoff value for predicting DCI was 5275 pg/ml (sensitivity: 68.42%, specificity: 82.86%).
Serum calprotectin concentrations within 48 hours after onset was significantly correlated with the clinical severity and the poor prognosis at 3 months in aSAH patients, suggesting that serum calprotectin may be a biomarker for early prediction of prognosis and complications in patients with aSAH and calprotectin may be a target for the treatment of aSAH.
探讨早期血清钙卫蛋白（S100A8/A9）水平与动脉瘤性蛛网膜下腔出血（aSAH）患者疾病严重程度及预后的关系。
收集54例aSAH患者（发病48小时内）及54例健康对照者的血清样本。采用酶联免疫吸附测定法测定血清钙卫蛋白水平。收集aSAH患者的临床资料。在3个月时采用改良Rankin量表评估预后。分别进行单因素和多因素逻辑回归分析、双变量相关性分析及受试者工作特征（ROC）曲线分析。
aSAH患者血清钙卫蛋白水平显著高于健康对照者（P <.001）。临床严重程度也与血清钙卫蛋白水平显著相关。3个月预后不良的患者发病48小时内血清钙卫蛋白水平高于预后良好的患者（P = .002）。发病48小时内血清钙卫蛋白水平与继发性肺炎并发症有关。血清钙卫蛋白可作为aSAH后迟发性脑缺血（DCI）及aSAH患者3个月预后不良的独立预测指标。ROC曲线显示，钙卫蛋白预测3个月预后不良的截断值为6020 pg/ml（灵敏度：53.57%，特异性：96.15%），预测DCI的截断值为5275 pg/ml（灵敏度：68.42%，特异性：82.86%）。
发病后48小时内血清钙卫蛋白浓度与aSAH患者的临床严重程度及3个月时的不良预后显著相关，提示血清钙卫蛋白可能是aSAH患者预后及并发症早期预测的生物标志物，且钙卫蛋白可能是aSAH治疗的靶点。
