脑脊液中高级氧化蛋白产物水平与动脉瘤性蛛网膜下腔出血早期脑损伤及预后的关系：一项初步前瞻性研究。
Association of cerebrospinal fluid advanced oxidation protein products levels with early brain injury and prognosis of aneurysmal subarachnoid hemorrhage: A preliminary prospective study.
机构信息
School of Clinical Medicine, Yuncheng Central Hospital, Shanxi Medical University, No. 3690, Hedong East Street, Yuncheng, Shanxi 044000, China.
School of Public Health, Shanxi Medical University, No.56, Xinjian South Road, Taiyuan, Shanxi 030000, China.
出版信息
J Stroke Cerebrovasc Dis. 2022 Sep;31(9):106635. doi: 10.1016/j.jstrokecerebrovasdis.2022.106635. Epub 2022 Jul 8.
OBJECTIVES
In this study, we investigated the time course in the cerebrospinal fluid (CSF) advanced oxidation protein products (AOPPs) levels in patients with aneurysmal subarachnoid hemorrhage (aSAH), and ascertained the relationship between the levels of AOPPs and early brain injury (EBI), hydrocephalus and prognosis of patients with aSAH.
METHODS
We measured the CSF AOPPs levels in 50 patients with aSAH at 1-3 d, 4-6 d, 7-9 d, and 10-12 d after hemorrhage. The modified Fisher grades, Hunt-Hess grades, CSF IL-6 levels, peripheral blood count of white blood cells, cerebral edema scores and hydrocephalus were used to assess the severity of brain injury. Modified Rankin Scale (mRS) scores were used to assess the prognosis. Patients with mRS scores greater than 2 were considered to have a poor outcome.
RESULTS
CSF AOPPs levels were significantly higher in patients with aSAH with poor prognosis, compared to patients with good prognosis and peaked in the early stage. Among patients with aSAH, the levels of CSF AOPPs on days 1-3 were significantly correlated with modified Fisher grades, Hunt-Hess grades, CSF IL-6 levels, peripheral blood count of white blood cells, and cerebral edema scores. Also, in patients with hydrocephalus, early CSF AOPPs levels were significantly elevated. Levels of CSF AOPPs in aSAH patients on days 1-3, 4-6, and 7-9 were independently associated with poor prognosis at the 90-day follow-up, and the optimal area under the curve (AUC) values for CSF AOPPs levels were found on days 1-3.
CONCLUSIONS
AOPPs may serve as the potential biomarker to assess the severity of EBI and prognosis in patients with aSAH.
目的
本研究旨在探讨动脉瘤性蛛网膜下腔出血（aSAH）患者脑脊液（CSF）中晚期氧化蛋白产物（AOPPs）水平的时间变化，并确定 AOPPs 水平与早期脑损伤（EBI）、脑积水和 aSAH 患者预后的关系。
方法
我们测量了 50 例 aSAH 患者出血后 1-3 天、4-6 天、7-9 天和 10-12 天的 CSF AOPPs 水平。改良 Fisher 分级、Hunt-Hess 分级、CSF IL-6 水平、外周血白细胞计数、脑水肿评分和脑积水用于评估脑损伤严重程度。改良 Rankin 量表（mRS）评分用于评估预后。mRS 评分大于 2 分的患者被认为预后不良。
结果
预后不良的 aSAH 患者 CSF AOPPs 水平明显高于预后良好的患者，且在早期达到峰值。在 aSAH 患者中，CSF AOPPs 水平在第 1-3 天与改良 Fisher 分级、Hunt-Hess 分级、CSF IL-6 水平、外周血白细胞计数和脑水肿评分显著相关。此外，在脑积水患者中，早期 CSF AOPPs 水平明显升高。aSAH 患者第 1-3 天、第 4-6 天和第 7-9 天的 CSF AOPPs 水平与 90 天随访时的预后不良独立相关，CSF AOPPs 水平的最佳曲线下面积（AUC）值出现在第 1-3 天。
结论
AOPPs 可能成为评估 aSAH 患者 EBI 严重程度和预后的潜在生物标志物。
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