血管痉挛生物标志物的进展——迈向未来基于血液的诊断测试
Advances in biomarkers for vasospasm - Towards a future blood-based diagnostic test.
作者信息
Mittal Aditya M, Nowicki Kamil W, Mantena Rohit, Cao Catherine, Rochlin Emma K, Dembinski Robert, Lang Michael J, Gross Bradley A, Friedlander Robert M
机构信息
University of Pittsburgh Medical Center, Department of Neurosurgery, Pittsburgh, PA, USA.
Yale University, Department of Neurosurgery, New Haven, CT, USA.
出版信息
World Neurosurg X. 2024 Mar 3;22:100343. doi: 10.1016/j.wnsx.2024.100343. eCollection 2024 Apr.
OBJECTIVE
Cerebral vasospasm and the resultant delayed cerebral infarction is a significant source of mortality following aneurysmal SAH. Vasospasm is currently detected using invasive or expensive imaging at regular intervals in patients following SAH, thus posing a risk of complications following the procedure and financial burden on these patients. Currently, there is no blood-based test to detect vasospasm.
METHODS
PubMed, Web of Science, and Embase databases were systematically searched to retrieve studies related to cerebral vasospasm, aneurysm rupture, and biomarkers. The study search dated from 1997 to 2022. Data from eligible studies was extracted and then summarized.
RESULTS
Out of the 632 citations screened, only 217 abstracts were selected for further review. Out of those, only 59 full text articles met eligibility and another 13 were excluded.
CONCLUSIONS
We summarize the current literature on the mechanism of cerebral vasospasm and delayed cerebral ischemia, specifically studies relating to inflammation, and provide a rationale and commentary on a hypothetical future bloodbased test to detect vasospasm. Efforts should be focused on clinical-translational approaches to create such a test to improve treatment timing and prediction of vasospasm to reduce the incidence of delayed cerebral infarction.
目的
脑血管痉挛及由此导致的迟发性脑梗死是动脉瘤性蛛网膜下腔出血(SAH)后死亡的重要原因。目前,SAH患者需定期通过侵入性或昂贵的影像学检查来检测血管痉挛,这会带来检查相关并发症风险及患者经济负担。目前尚无基于血液的检测方法来检测血管痉挛。
方法
系统检索PubMed、科学网和Embase数据库,以获取与脑血管痉挛、动脉瘤破裂和生物标志物相关的研究。研究检索时间为1997年至2022年。提取符合条件研究的数据,然后进行总结。
结果
在筛选的632篇文献中,仅217篇摘要被选作进一步审查。其中,仅59篇全文文章符合条件,另有13篇被排除。
结论
我们总结了目前关于脑血管痉挛和迟发性脑缺血机制的文献,特别是与炎症相关的研究,并对未来一种用于检测血管痉挛的基于血液的假想检测方法提供了理论依据和评论。应将努力集中在临床转化方法上,以创建这样一种检测方法,改善血管痉挛的治疗时机和预测,降低迟发性脑梗死的发生率。