Dai Junxia, Lin Qun, Ye Liangzhi, Chen Xiaoxiang, Li Zhiwei, Lu Chuan, Chen Maohua, Ba Huajun, Sun Jun, Cai Jianyong
Department of Neurosurgery, Laboratory of Pan-Vascular Disease Management Center, The Dingli Clinical College of Wenzhou Medical University, The Wenzhou Central Hospital, Wenzhou, 325000, People's Republic of China.
Int J Gen Med. 2025 Feb 1;18:567-584. doi: 10.2147/IJGM.S508325. eCollection 2025.
Homer scaffold protein 1 (homer1) may harbor neuroprotective effects against acute brain injury. This study aimed to investigate the prognostic role of serum homer1 in human aneurysmal subarachnoid hemorrhage (aSAH).
A total of 209 patients with aSAH and 100 controls were encompassed in this prospective cohort study. Serum homer1 levels were quantified at admission in all patients, on post-aSAH days 1, 3, 5, 7, 10, and 14 in 83 patients and at recruitments in controls. The modified Fisher scale (mFisher) and World Federation of Neurological Surgeons Scale (WFNS) were used for severity assessment. Glasgow Outcome Scale (GOS) scores of 1-3 at post-aSAH 90 days indicated poor prognosis.
Serum homer1 levels of patients were abruptly elevated at admission, peaked at day 3, and afterwards decreased from day 5 until day 14 after aSAH, and were markedly higher during 14 days than those of controls. Serum homer1 levels were linearly and independently correlated with WFNS scores, mFisher scores, continuous GOS scores, ordinal GOS scores, poor prognosis risk and delayed cerebral ischemia (DCI) likelihood. DCI partially mediated association of serum homer1 levels with poor prognosis. The prognosis model was composed of the four independent predictors, that is serum homer1 levels, DCI, WFNS scores and mFisher scores. As demonstrated by a series of statistical methods, the model had a good performance.
Serum homer1 levels are significantly elevated in acute phase after aSAH, and are strongly related to heightened bleeding intensity, poor 90-day prognosis and DCI. Nevertheless, associational mechanism of serum homer1 and poor prognosis mediated by DCI needs to be further deciphered.
荷马支架蛋白1（homer1）可能对急性脑损伤具有神经保护作用。本研究旨在探讨血清homer1在人类动脉瘤性蛛网膜下腔出血（aSAH）中的预后作用。
这项前瞻性队列研究共纳入209例aSAH患者和100例对照。所有患者在入院时、83例患者在aSAH后第1、3、5、7、10和14天以及对照在招募时测定血清homer1水平。采用改良Fisher量表（mFisher）和世界神经外科医师联合会量表（WFNS）进行严重程度评估。aSAH后90天格拉斯哥预后量表（GOS）评分为1 - 3分表明预后不良。
患者血清homer1水平在入院时突然升高，在第3天达到峰值，随后在aSAH后第5天至第14天下降，且在14天内明显高于对照组。血清homer1水平与WFNS评分、mFisher评分、连续GOS评分、序贯GOS评分、预后不良风险和延迟性脑缺血（DCI）可能性呈线性且独立相关。DCI部分介导血清homer1水平与预后不良的关联。预后模型由四个独立预测因素组成，即血清homer1水平、DCI、WFNS评分和mFisher评分。一系列统计方法表明该模型具有良好的性能。
aSAH急性期血清homer1水平显著升高，且与出血强度增加、90天预后不良和DCI密切相关。然而，血清homer1与DCI介导的预后不良的关联机制有待进一步阐明。
