摘要
目的 探讨动脉瘤性蛛网膜下腔出血(aSAH)患者血管内介入栓塞术后,脑脊液中正五聚蛋白3(PTX3)水平与患者病情的关系及对预后的影响。方法 本研究回顾性分析了65名在郑州大学附属洛阳中心医院接受血管内介入栓塞手术治疗的aSAH患者,所有患者于术后24 h内采集脑脊液并检测PTX3水平,探讨脑脊液中PTX3水平与患者入院时病情的关系。此外,根据出院3个月时改良Rankin分级(mRS)将患者分为预后良好组和预后不良组,比较2组患者各项临床资料并采用多因素Logistic回归分析明确影响其预后的独立危险因素。结果 预后不良组患者脑脊液PTX3水平高于预后良好组(P<0.001),脑脊液PTX3水平与入院时Hunt-Hess分级(r=0.440,P<0.001)、世界神经外科联合会(WFNS)分级(r=0.504,P<0.001)和改良Fisher(mFisher)分级(r=0.557,P<0.001)呈正相关性。多因素Logistic回归分析结果显示,脑脊液PTX3≥2.007ng/ml(OR=10.31,95%CI:1.46~72.65,P=0.019)、WFNS分级≥3(OR=7.28,95%CI:1.23~42.95,P=0.028)、Hunt-Hess分级≥3(OR=6.52,95%CI:1.31~32.33,P=0.022)是3个月不良预后的独立危险因素。结论 aSAH患者血管内介入栓塞术后24 h内脑脊液中PTX3水平与入院时Hunt-Hess、WFNS、mFisher分级密切相关,并且与患者3个月不良预后独立相关,证实脑脊液中PTX3可作为评估aSAH后病情严重程度和预后的潜在炎性生物标志物。
Objective To investigate the relationship between the level of pentraxin 3(PTX3) in cerebrospinal fluid and state of illness and prognosis in the patients with aneurysmal subarachnoid hemorrhage(aSAH) after endovascular embolization.Methods In the study,65 patients with aSAH who received endovascular embolization in the hospital were retrospectively analyzed.Cerebrospinal fluid was collected within 24 hours after surgery and the level of PTX3 was detected to explore the relationship between the level of PTX3 in CSF and state of illness at admission.In addition,by using the modified Rankin score(mRS) 3 months after discharge,the patients were divided into the good prognosis group and the poor prognosis group.The clinical data of the two groups were compared and multivariate Logistic regression analysis was made to identify independent risk factors affecting prognosis.Results The level of PTX3 in cerebrospinal fluid in the poor prognosis group was significantly higher than that in the good prognosis group(P<0.001).The level of PTX3 in cerebrospinal fluid was positively correlated with Hunt Hess scores(r=0.440,P<0.001),World Federation of Neurosurgery Societies(WFNS) scores(r=0.504,P<0.001) and modified Fisher(mFisher) scores(r=0.557,P<0.001) at admission.Multivariate Logistic regression analysis showed that such factors as cerebrospinal fluid PTX3≥2.007 ng/ml(OR=10.31,95%CI:1.46-72.65,P=0.019),WFNS scores≥3(OR=7.28,95%CI:1.23-42.95,P=0.028) and Hunt Hess scores>3(OR=6.52,95%CI:1.31-32.3,P=0.022) were independent risk factors of poor prognosis,3 months after discharge.Conclusion The level of PTX3 in cerebrospinal fluid of the patients with aSAH after surgery was positively correlated with the severity of the disease,and the high level of PTX3 was an independent risk factor for poor prognosis three months after discharge.
作者
吕亚兵
姚庆和
Lyu Yabing;Yao Qinghe(Department of Neurosurgery,Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《海军医学杂志》
2022年第10期1141-1145,共5页
Journal of Navy Medicine
作者简介
通信作者:姚庆和,电子信箱:yaoqinghe2005@163.com。
