Li Hailong, Li Donghua, Li Mi, Hu Zehong
Department of Neurosurgery, Panzhihua Central Hospital, Panzhihua City, Sichuan Province, People's Republic of China.
Int J Gen Med. 2024 Sep 25;17:4347-4358. doi: 10.2147/IJGM.S468549. eCollection 2024.
To analyze the predictive value of protein kinase C (PKC) and endothelin-1 (ET-1) in cerebrospinal fluid for vasospasm and prognosis in patients with aneurysmal subarachnoid hemorrhage (ASH).
One hundred and forty-eight ASH patients hospitalized in our hospital during February 2019 to February 2022 were optioned as observation subjects. These subjects were graded into good prognosis group (mRS score 0-2, n = 102) and poor prognosis group (mRS score 3-6, n = 46) according to the Rankin Revised Scale Score (mRS) after 6 months of follow-up. Cerebrospinal fluid was collected from patients to detect the content of ET-1 and PKC. The prognostic factors were analyzed using multifactorial logistic regression. The predictive value was assessed using receiver operating characteristic (ROC) curve.
The patients with poor prognosis had a higher age level and a higher proportion of ≥2 aneurysms, aneurysm diameter ≥6 mm, cerebral vasospasm, and Hunt-Hess grade ≥III than those with good prognosis ( < 0.05). The patients with poor prognosis had higher content of PKC and ET-1 than those with good prognosis ( < 0.05). Age, aneurysm diameter ≥6 mm, cerebral vasospasm, Hunt-Hess classification ≥grade III, PKC and ET-1 were all risk factors related to the prognosis of ASH ( < 0.05). The area under the curve (AUC) of PKC and ET-1 for diagnosing poor prognosis of ASH was 0.803 and 0.720, respectively. The AUC of the combined detection was 0.873 ( < 0.05). Patients with cerebrovascular spasm had higher content of PKC and ET-1 than those without ( < 0.05). The AUC of PKC and ET-1 for diagnosing cerebral vasospasm in ASH was 0.891 and 0.816, respectively, which was 0.932 for combined detection ( < 0.05).
The combination of PKC and ET-1 in cerebrospinal fluid had certain value in predicting the poor prognosis of patients with ASH.
分析脑脊液中蛋白激酶C（PKC）和内皮素-1（ET-1）对动脉瘤性蛛网膜下腔出血（ASH）患者血管痉挛及预后的预测价值。
选取2019年2月至2022年2月在我院住院的148例ASH患者作为观察对象。根据随访6个月后的改良Rankin量表评分（mRS）将这些患者分为预后良好组（mRS评分0 - 2，n = 102）和预后不良组（mRS评分3 - 6，n = 46）。采集患者脑脊液检测ET-1和PKC含量。采用多因素logistic回归分析预后相关因素。利用受试者工作特征（ROC）曲线评估预测价值。
预后不良组患者的年龄水平更高，≥2个动脉瘤、动脉瘤直径≥6 mm、脑血管痉挛以及Hunt-Hess分级≥Ⅲ级的比例高于预后良好组（P < 0.05）。预后不良组患者的PKC和ET-1含量高于预后良好组（P < 0.05）。年龄、动脉瘤直径≥6 mm、脑血管痉挛、Hunt-Hess分级≥Ⅲ级、PKC和ET-1均为与ASH预后相关的危险因素（P < 0.05）。PKC和ET-1诊断ASH预后不良的曲线下面积（AUC）分别为0.803和0.720。联合检测的AUC为0.873（P < 0.05）。发生脑血管痉挛的患者PKC和ET-1含量高于未发生者（P < 0.05）。PKC和ET-1诊断ASH患者脑血管痉挛的AUC分别为0.891和0.816，联合检测为0.932（P < 0.05）。
脑脊液中PKC与ET-1联合检测对预测ASH患者预后不良具有一定价值。
