第 14 天血清 C 反应蛋白值作为动脉瘤性蛛网膜下腔出血的可能预后因素。
Serum C-reactive protein value on day 14 as a possible prognostic factor of aneurysmal subarachnoid hemorrhage.
机构信息
Department of Neurosurgery, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa, Japan.
出版信息
J Int Med Res. 2024 May;52(5):3000605241253755. doi: 10.1177/03000605241253755.
OBJECTIVE
Serum C-reactive protein (CRP), as a reflection of early brain injury at onset, is a prognostic factor in aneurysmal subarachnoid hemorrhage (aSAH). However, in some severe cases, patients exhibit a good prognosis despite their elevated serum CRP level. Therefore, we examined the relationship between serum CRP transitions in the acute phase of aSAH and the prognosis.
METHODS
We recruited 63 patients with aSAH and retrospectively analyzed the relationships between the serum CRP transitions during the acute phase and the prognosis, patient background, and clinical course.
RESULTS
Serum CRP values on days 1, 3, and 14 were significantly lower in the good prognosis group than those in the poor prognosis group. Moreover, serum CRP values on days 1 and 14 significantly affected the prognosis in the multiple regression analysis.
CONCLUSIONS
A low serum CRP value on day 14, in addition to that on day 1 as reported previously, is associated with a good prognosis of aSAH. Furthermore, a good prognosis of aSAH is determined not only by absence of early brain injury at onset but also by appropriate management to obtain a low serum CRP value on day 14.
目的
血清 C 反应蛋白（CRP）作为发病时早期脑损伤的反映，是蛛网膜下腔出血（aSAH）的预后因素。然而，在一些严重的情况下，尽管患者的血清 CRP 水平升高，但预后良好。因此，我们研究了 aSAH 急性期血清 CRP 变化与预后之间的关系。
方法
我们招募了 63 例 aSAH 患者，回顾性分析了急性期血清 CRP 变化与预后、患者背景和临床病程之间的关系。
结果
在预后良好组中，血清 CRP 值在第 1、3 和 14 天明显低于预后不良组。此外，多元回归分析显示，第 1 和第 14 天的血清 CRP 值对预后有显著影响。
结论
与以前报道的第 1 天一样，第 14 天的低血清 CRP 值与 aSAH 的良好预后相关。此外，aSAH 的良好预后不仅取决于发病时是否存在早期脑损伤，还取决于适当的管理，以在第 14 天获得低血清 CRP 值。
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