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血清膜联蛋白 A1 预测动脉瘤性蛛网膜下腔出血后 6 个月不良临床结局的能力。

Ability of serum annexin A1 to predict 6-month poor clinical outcome following aneurysmal subarachnoid hemorrhage.

机构信息

Department of Neurosurgery, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), 568 North Zhongxing Road, Shaoxing 312000, Zhejiang Province, PR China.

Department of Neurosurgery, Affiliated Hospital of Shaoxing University (Shaoxing Municipal Hospital), 999 South Zhongxing Road, Shaoxing 312000, Zhejiang Province, PR China.

出版信息

Clin Chim Acta. 2021 Aug;519:142-147. doi: 10.1016/j.cca.2021.04.020. Epub 2021 Apr 28.

Abstract

BACKGROUND

Annexin A1 might be neuroprotective and serum annexin A1 concentrations were markedly declined after severe traumatic brain injury. We determine dthe ability of serum annexin A1 to assess severity and predict prognosis after aneurysmal subarachnoid hemorrhage (aSAH).

METHODS

We included 157 aSAH patients and 157 healthy subjects. Serum annexin A1 measurements were measured. A poor outcome was designated as Glasgow outcome scale score of 1-3. Multivariate logistic regression analysis was applied to identify predictors of a poor 6-month outcome.

RESULTS

Serum annexin A1 concentrations were significantly lower in patients than in controls. Annexin A1 concentrations were strongly correlated with the World Federation of Neurological Surgeons scale (WFNS) score, Hunt-Hess score, Glasgow coma scale score and modified Fisher score. A total of 59 patients (37.6%) experienced a poor outcome. Serum annexin A1, WFNS score and modified Fisher score emerged as the 3 independent predictors for a poor outcome after aSAH. Under ROC curve analysis, serum annexin A1 had a fair accuracy to predict a poor outcome, AUC of serum annexin A1 concentration was equivalent to those of WFNS score and modified Fisher score and AUC of combination of the 3 factors significantly exceeded that of each one alone.

CONCLUSIONS

Annexin A1 may be involved in the occurrence and progression of secondary brain injury after aSAH. Detection of serum annexin A1 may have certain ability for assessment of severity and prediction of long-term prognosis following aSAH.

摘要

背景

膜联蛋白 A1 可能具有神经保护作用,且在严重创伤性脑损伤后血清膜联蛋白 A1 浓度明显下降。我们旨在确定血清膜联蛋白 A1 评估蛛网膜下腔出血(aSAH)严重程度和预测预后的能力。

方法

我们纳入了 157 例 aSAH 患者和 157 例健康对照者。测量了血清膜联蛋白 A1 水平。格拉斯哥预后量表评分 1-3 分定义为预后不良。采用多变量逻辑回归分析确定预后不良的 6 个月的预测因素。

结果

与对照组相比,患者的血清膜联蛋白 A1 浓度明显降低。膜联蛋白 A1 浓度与世界神经外科学联合会(WFNS)分级、Hunt-Hess 分级、格拉斯哥昏迷量表评分和改良 Fisher 分级均呈强相关。共有 59 例患者(37.6%)预后不良。血清膜联蛋白 A1、WFNS 分级和改良 Fisher 评分是 aSAH 预后不良的 3 个独立预测因素。在 ROC 曲线分析中,血清膜联蛋白 A1 对预测预后不良有一定的准确性,血清膜联蛋白 A1 浓度的 AUC 与 WFNS 分级和改良 Fisher 评分相当,3 个因素联合的 AUC 明显优于各因素单独的 AUC。

结论

膜联蛋白 A1 可能参与了 aSAH 后继发性脑损伤的发生和进展。检测血清膜联蛋白 A1 可能对评估 aSAH 严重程度和预测长期预后具有一定能力。

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