Fu Zhengjie, Dai Junxia, Lin Qun, Ye Liangzhi, Chen Xiaoxiang, Li Zhiwei, Lu Chuan, Chen Maohua, Ba Huajun, Sun Jun, Cai Jianyong
Department of Neurosurgery, The Dingli Clinical College of Wenzhou Medical University, The Wenzhou Central Hospital, 252 Bailidong Road, Wenzhou, 325000, China.
Neurosurg Rev. 2025 May 10;48(1):412. doi: 10.1007/s10143-025-03565-3.
Peroxiredoxin 2 (Prdx2), an oxidative mediator, participates in acute brain injury. Here, serum Prdx2 levels were measured in order to assess its prognostic significance in aneurysmal subarachnoid hemorrhage (aSAH). In this prospective cohort study, serum Prdx2 levels were detected in 100 controls and 161 patients with aSAH. The modified Fisher scale (mFisher) and World Federation of Neurological Surgeons Scale (WFNS) were selected as two severity metrics. Post-aSAH 6-month Glasgow outcome scale (GOS) score of 1-3 was termed as poor prognosis. Poor prognosis and delayed cerebral ischemia (DCI) were chosen as two outcome variables of interest. Severity correlation and prognosis association with serum Prdx2 levels were investigated using multiple factorial approaches. Patients had markedly higher serum Prdx2 levels than controls. Serum Prdx2 levels, in independent correlation with WFNS scores and mFisher scores, were independently associated with DCI, poor prognosis, continuous GOS scores and ordinal GOS scores. Serum Prdx2 levels and two other independent predictors, that is WFNS scores and mFisher scores, were merged to form two models for predicting DCI and poor prognosis respectively. The two models were visually represented via the nomogram, and occupied satisfactory validity, stability and discrimination efficiency under decision curve, calibration curve and receiver operating characteristic curve. Serum Prdx2 levels of substantial promotion after aSAH are firmly linked to severity, DCI and bad 6-month prognosis of patients, strengthening serum Prdx2 as a useful prognostic biomarker of aSAH.
过氧化物酶2（Prdx2）作为一种氧化介质，参与急性脑损伤。在此，检测血清Prdx2水平以评估其在动脉瘤性蛛网膜下腔出血（aSAH）中的预后意义。在这项前瞻性队列研究中，检测了100名对照者和161例aSAH患者的血清Prdx2水平。选择改良Fisher量表（mFisher）和世界神经外科医师联合会量表（WFNS）作为两种严重程度指标。aSAH后6个月格拉斯哥预后量表（GOS）评分为1 - 3分被定义为预后不良。选择预后不良和迟发性脑缺血（DCI）作为两个感兴趣的结局变量。使用多因素方法研究血清Prdx2水平与严重程度的相关性以及与预后的关联。患者的血清Prdx2水平明显高于对照者。血清Prdx2水平与WFNS评分和mFisher评分独立相关，与DCI、预后不良、连续GOS评分和有序GOS评分独立相关。将血清Prdx2水平与另外两个独立预测因子，即WFNS评分和mFisher评分合并，分别构建预测DCI和预后不良的两个模型。通过列线图直观呈现这两个模型，并且在决策曲线、校准曲线和受试者工作特征曲线下具有令人满意的有效性、稳定性和区分效率。aSAH后血清Prdx2水平显著升高与患者的严重程度、DCI和6个月不良预后密切相关，强化了血清Prdx2作为aSAH有用的预后生物标志物的作用。
