Qin Jinhui, Zhu Xingyang, Wang Xiaoli, Cheng Xiangjie
Nanyang Second General Hospital, Department of Cerebrovascular Intervention, Henan Province, China.
J Med Biochem. 2025 Aug 21;44(5):1038-1049. doi: 10.5937/jomb0-55011.
Cerebral venous sinus thrombosis (CVST) with concurrent brain parenchymal injury is a severe and complex condition that requires effective treatment strategies and long-term follow-ups. This study aimed to evaluate the prognostic value of serum caspase-cleaved cytokeratin-18 (CCCK-18), neuron-specific enolase (N SE), S-100P, nerve growth factor (N GF), and CRP D-Dimer, and EPO in CVST treatment.
Ninety patients with CVST combined with parenchymal brain had undergone systemic anticoagulant therapy (SAT group) or vascular interventional therapy (VIT group) at Nanyang Second General Hospital from January 2021 to January 2024 were evaluated in this study with 45 patients in each group. Three months after discharge, mRS, NIHSS, GCS, and patients' quality of life were assessed. Peripheral blood samples were collected to measure CRP D-Dimer, EPO, and CCCK-18 level changes. The levels of serum neuron-specific enolase (NSE), S100P, and nerve growth factor (NGF) were compared before and at 3 and 7 days post-treatment. Follow-up at six months post-discharge included calculations of mortality and recanalisation rates.
At 3 months post-discharge, 11.1% of VIT patients had an mRSS2, compared to 35.6% in the SAT group (P< 0.05). The VIT group also had lower NIHSS scores, higher GCS and SF-36 scores, and lower serum CRP EPO, and CCCK-8 levels (P< 0.05). NSE and S-100P levels were lower in the VIT group at 7 days post-treatment (P< 0.05), while NGF levels were higher at 3 days post-treatment (P< 0.05). Follow-up showed no significant difference in survival rates (88.9% vs 95.6%). Still, the VIT group had a lower proportion of patients with mRS>2 (20.0% vs 42.2%) and a higher complete recanalisation rate (73.3% vs 53.3%) (both P< 0.05).
Combined SAT with neurovascular interventional thrombectomy benefits patients with CVST and concurrent brain parenchymal injury by promoting recovery of neurological deficits and consciousness, achieving vascular recanalisation.
伴有脑实质损伤的脑静脉窦血栓形成（CVST）是一种严重且复杂的病症，需要有效的治疗策略和长期随访。本研究旨在评估血清半胱天冬酶切割细胞角蛋白-18（CCCK-18）、神经元特异性烯醇化酶（NSE）、S-100P、神经生长因子（NGF）、C反应蛋白（CRP）、D-二聚体和促红细胞生成素（EPO）在CVST治疗中的预后价值。
本研究对2021年1月至2024年1月在南阳第二人民医院接受全身抗凝治疗（SAT组）或血管介入治疗（VIT组）的90例CVST合并脑实质损伤患者进行评估，每组45例。出院后3个月，评估改良Rankin量表（mRS）、美国国立卫生研究院卒中量表（NIHSS）、格拉斯哥昏迷量表（GCS）和患者生活质量。采集外周血样本以测量CRP、D-二聚体、EPO和CCCK-18水平变化。比较治疗前、治疗后3天和7天血清神经元特异性烯醇化酶（NSE）、S100P和神经生长因子（NGF）水平。出院后6个月随访包括计算死亡率和再通率。
出院后3个月，VIT组11.1%的患者mRS≤2，而SAT组为35.6%（P<0.05）。VIT组的NIHSS评分也较低，GCS和SF-36评分较高，血清CRP、EPO和CCCK-18水平较低（P<0.05）。治疗后7天VIT组的NSE和S-100P水平较低（P<0.05），而治疗后3天NGF水平较高（P<0.05）。随访显示生存率无显著差异（88.9%对95.6%）。然而，VIT组mRS>2的患者比例较低（20.0%对42.2%），完全再通率较高（73.3%对53.3%）（均P<0.05）。
全身抗凝治疗联合神经血管介入取栓术可促进神经功能缺损和意识恢复，实现血管再通，对CVST合并脑实质损伤患者有益。
