Neurointensive Care Unit, The First Affiliated Hospital of Yangtze University, Jingzhou, China.
Department of Hematology, The First Affiliated Hospital of Yangtze University, Jingzhou, China.
Medicine (Baltimore). 2024 Oct 11;103(41):e40027. doi: 10.1097/MD.0000000000040027.
Aneurysmal subarachnoid hemorrhage is an acute cerebrovascular disease with high disability and mortality. We intended to explore the association between levels of erythrocytes in cerebrospinal fluid at different times of hemorrhage and the outcome of patients. One retrospective study including 216 patients with aneurysmal subarachnoid hemorrhage undergoing surgeries in the First Affiliated Hospital of Yangtze University from January 2020 to July 2023 was carried. The univariable analysis and multivariable logistic regression analysis were used for factors associated with poor outcome. The level of erythrocytes in cerebrospinal fluid on the 1st postoperative day in patients with poor outcome was 311 × 103/µL, significantly higher than patients with good outcome (108 × 103/µL), P < .001. The level of erythrocytes in cerebrospinal fluid on 7th postoperative day was 86.5 × 103/µL, also significantly higher than patients with good outcome (26.0 × 103/µL). The multivariable logistic regression analysis results showed that erythrocytes in cerebrospinal fluid on the 1st postoperative day (≥177 × 103/µL) and on the 7th postoperative day (≥53.5 × 103/µL) were possibly associated with poor outcome in aneurysmal subarachnoid hemorrhage patients. Treatment with tranexamic acid and continuous lumbar drainage did not result in a decrease of erythrocytes in cerebrospinal fluid. Higher erythrocytes in cerebrospinal fluid on the 1st and 7th postoperative days were associated with poor outcome in aneurysmal subarachnoid hemorrhage patients.
颅内动脉瘤性蛛网膜下腔出血是一种高残疾和高死亡率的急性脑血管病。本研究旨在探讨出血不同时间点脑脊液中红细胞水平与患者预后的关系。本研究回顾性分析了 2020 年 1 月至 2023 年 7 月在长江大学第一附属医院接受手术治疗的 216 例颅内动脉瘤性蛛网膜下腔出血患者的临床资料。采用单因素分析和多因素 logistic 回归分析探讨与不良预后相关的因素。结果显示，预后不良患者术后第 1 天脑脊液红细胞水平为 311×103/µL，明显高于预后良好患者（108×103/µL），P<0.001。术后第 7 天脑脊液红细胞水平为 86.5×103/µL，亦明显高于预后良好患者（26.0×103/µL）。多因素 logistic 回归分析结果显示，术后第 1 天（≥177×103/µL）和第 7 天（≥53.5×103/µL）脑脊液红细胞水平与颅内动脉瘤性蛛网膜下腔出血患者的不良预后可能相关。使用氨甲环酸和持续腰椎引流并不能降低脑脊液中的红细胞水平。术后第 1 天和第 7 天脑脊液中红细胞水平较高与颅内动脉瘤性蛛网膜下腔出血患者的不良预后相关。
