[1]丁锐,刘熙至,赵子龙,等.早期外周血炎症指标与动脉瘤性蛛网膜下腔出血临床转归的相关性[J].中国临床神经外科杂志,2024,29(10):586-589615.[doi:10.13798/j.issn.1009-153X.2024.10.003]
　DING Rui,LIU Xi-zhi,ZHAO Zi-long,et al.Correlation between the early peripheral blood inflammatory markers after hemorrhage and the clinical outcome of aneurysmal subarachnoid hemorrhage[J].,2024,29(10):586-589615.[doi:10.13798/j.issn.1009-153X.2024.10.003]
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早期外周血炎症指标与动脉瘤性蛛网膜下腔出血临床转归的相关性()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年10期
页码:
586-589615
栏目:
论著
出版日期:
2024-10-30

文章信息/Info

Title:
Correlation between the early peripheral blood inflammatory markers after hemorrhage and the clinical outcome of aneurysmal subarachnoid hemorrhage
文章编号:
1009-153X（2024）10-0586-04
作者:
丁锐; 刘熙至; 赵子龙; 陈治标; 谢腾; 吴立权
430060武汉，武汉大学人民医院神经外科（丁锐、刘熙至、赵子龙、陈治标、吴立权）；431600湖北，汉川市人民医院神经外科（谢腾）
Author(s):
DING Rui1;  LIU Xi-zhi1;  ZHAO Zi-long1;  CHEN Zhi-biao1;  XIE Teng2;  WU Li-quan1
1. Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, China; 2. Department of Neurosurgery, Hanchuan Renmin Hospital, Hanchuan 431600, China
关键词:
动脉瘤性蛛网膜下腔出血; 迟发性脑缺血; 临床预后; 外周血; 炎症指标
Keywords:
Aneurysmal subarachnoid hemorrhage;  Inflammatory markers;  Peripheral blood;  Delayed cerebral ischemia;  Pronosis
分类号:
R 743.9
DOI:
10.13798/j.issn.1009-153X.2024.10.003
文献标志码:
A
摘要:
目的 探讨早期外周血炎症指标与动脉瘤性蛛网膜下腔出血（aSAH）后迟发性脑缺血（DCI）和临床预后的相关性。方法 2022年12月至2023年12月前瞻性收治符合标准的aSAH共44例，入院24 h内检测外周血炎症指标；发病3个月，根据GOS评分评估预后，其中4~5分为预后良好。结果 44例中，8例发生DCI，发生率为18.2%。发病3个月，GOS评分1分2例，2分3例，3分4例，4分2例，5分33例；预后良好率为79.55%。单因素logistic分析显示，入院白细胞计数（WBC）、中性粒细胞计数、血糖、中性粒细胞与淋巴细胞比值（NLR）、全身免疫炎症指数（SIRI）、入院Hunt-Hess分级和入院改良Fisher分级为aSAH并发DCI的影响因素（P<0.05）；入院时WBC、中性粒细胞计数、甘油三酯、血糖、NLR、SIRI、炎症预后指数、Hunt-Hess评分和Fisher评分为aSAH预后不良的影响因素（P<0.05）。ROC曲线分析显示，外周血白细胞介素-10水平对aSAH病人预后不良具有预测价值，曲线下面积为0.749（95% CI 0.560~0.938；P=0.022），最佳临界值为7.21 pg/ml，敏感度为0.667，特异度为0.829。结论 早期外周血炎症指标与aSAH后DCI和临床预后有关，早期外周血IL-10水平对aSAH预后有良好的预测价值。
Abstract:
Objective To investigate the relationship between the early peripheral blood inflammatory markers and the delayed cerebral ischemia (DCI) as well as the clinical prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods A total of 44 patients with aSAH that met the criteria were prospectively collected from December 2022 to December 2023. Peripheral blood inflammatory markers were detected within 24 hours of admission. Three months after the onset, prognosis was evaluated based on the Glasgow Outcome Scale (GOS) score, with a score of 4~5 indicating a favorable prognosis. Results Of the 44 patients, 8 patients developed DCI, with an incidence rate of 18.2%. Three months after the onset, the GOS scores were 1 point for 2 cases, 2 points for 3 cases, 3 points for 4 cases, 4 points for 2 cases, and 5 points for 33 cases; the favorable prognosis rate was 79.55%. Univariate logistic analysis revealed that white blood cell (WBC), neutrophil, blood glucose, neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SIRI), Hunt-Hess grade at admission, and modified Fisher grade at admission were the influencing factors for DCIin aSAH patients (P<0.05); WBC, neutrophil, triglyceride, blood glucose, NLR, SIRI, inflammatory prognostic index, Hunt-Hess score, and Fisher score at admission were the influencing factors for poor prognosis of aSAH (P<0.05). ROC curve analysis indicated that the level of interleukin-10 in peripheral blood had predictive value for poor prognosis in aSAH patients, with an area under the curve of 0.749 (95% CI 0.560~0.938; P=0.022), the optimal cut-off value being 7.21 pg/ml, the sensitivity being 0.667, and the specificity being 0.829. Conclusions Peripheral blood inflammatory indicators are associated with DCI and clinical prognosis after aSAH, and the level of IL-10 in peripheral blood has favorable predictive value for the prognosis of aSAH.

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备注/Memo

备注/Memo:
（2024-04-07收稿，2024-08-28修回）
基金项目: 湖北省重点研发计划（2022BCE020）
通信作者：吴立权，Email：wuliquan@whu.edu.cn
更新日期/Last Update: 2024-10-30