[1]王世龙,赵 冬,许 晖,等.血脂水平与动脉瘤性蛛网膜下腔出血后迟发性脑缺血的相关性[J].中国临床神经外科杂志,2016,(11):685-688.[doi:10.13798/j.issn.1009-153X.2016.11.011]
 WANG Shi-long,ZHAO Dong,XU Hui,et al.Relationship of serum lipid with delayed cerebral ischemia following the aneurysmal subarachnoid hemorrhage[J].,2016,(11):685-688.[doi:10.13798/j.issn.1009-153X.2016.11.011]
点击复制

血脂水平与动脉瘤性蛛网膜下腔出血后迟发性脑缺血的相关性()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年11期
页码:
685-688
栏目:
论著
出版日期:
2016-11-25

文章信息/Info

Title:
Relationship of serum lipid with delayed cerebral ischemia following the aneurysmal subarachnoid hemorrhage
文章编号:
1009-153X(2016)11-0685-04
作者:
王世龙赵 冬许 晖朱立仓刘 祺何学君王业忠
832008 新疆石河子,石河子大学医学院第一附属医院神经外科
Author(s):
WANG Shi-long ZHAO Dong XU Hui ZHU Li-cang LIU Qi HE Xue-jun WANG Ye-zhong.
Department of Neurosurgery, The First Affiliated Hospital, Medical School, Shihezi University, Shihezi 832008 China
关键词:
动脉瘤性蛛网膜下腔出血迟发性脑缺血血脂改良Fisher分级
Keywords:
Aneurysmal subarachnoid hemorrhage Delayed cerebral ischemia Serum level Lipid Modified Fisher grading
分类号:
R 743.9
DOI:
10.13798/j.issn.1009-153X.2016.11.011
文献标志码:
A
摘要:
目的 探讨血脂水平与动脉瘤性蛛网膜下腔出血(aSAH)后迟发性脑缺血(DCI)的相关性。方法 回顾性分析2014年1月至2015年12月收治的74例aSAH的临床资料,采用多因素Logistic回归分析检验性别、年龄、动脉瘤位置、动脉瘤大小、世界神经外科医师联盟(WFNS)分级、改良Fisher分级、Hunt-Hess分级、治疗方式、总甘油三脂、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、脂蛋白(a)、载脂蛋白A、载脂蛋白B等因素与DCI的关系。结果 74例中,65例入院后检测血脂,20例出现DCI,45例未出现DCI,aSAH后DCI的发生率为30.8%。多因素Logistic回归分析显示高甘油三酯及改良Fisher分级是aSAH后DCI发生的独立危险因素。结论 及时检测aSAH患者的血脂水平和对患者进行改良Fisher分级对DCI的诊断治疗均有参考价值。
Abstract:
Objective To explore the relationship between delayed cerebral ischemia (DCI) following the aneurysmal subarachnoid hemorrhage (aSAH) and serum level of lipid. Methods The clinical data of 74 patients with aSAH treated from January, 2014 to December, 2015 were analyzed retrospectively, including sex, age, location of aneurysms, size of aneurysms, World Federation of Neurosurgical Societies (WFNS) grade, modified Fisher grade, Hunt-Hess grade, treatment method, total and serum levels of triglyceride (TG), total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, lipoprotein(a), apolipoprotein A and apolipoprotein B. The relationship of the DCI with the above-mentioned factors was analyzed by single factor analysis and Logistic regression. Results Of 65 patients receiving the determination of serum lipid, 20 (30.8%) suffered from DCI and 45 did not. The single factor analysis showed that the serum level of TG was statistically higher and the percentage of the patients with modified Fisher grades 0, 1 and 2 was statistically lower in the patients with DCI than those in the patients without DCI (P<0.05). Logistic regression analysis showed that high serum TG level and low modified Fisher grade were risk factors of DCI following the aSAH. Discussion It is suggested that DCI easily occurred in the patients with high serum levels of TG and low modified Fisher grades following the aSAH.

参考文献/References:

[1] 姜睿璇,张 娟,边立衡. 2013年欧洲卒中组织关于颅内 动脉瘤及蛛网膜下腔出血的管理指南(第一部分)[J]. 中 国卒中杂志,2014,9(6):508-515.
[2] Ferguson S, Macdonald RL. Predictors of cerebral infarction in patients with aneurysmal subarachnoid hemorrhage [J]. Neurosurgery, 2007, 60(4): 658-667.
[3] Nordestgaard BG, Varbo A. Triglycerides and cardiovascular disease [J]. Lancet, 2014, 384(9943): 626-635.
[4] Maranh?o RC, Carvalho PO, Strunz CC, et al. Lipoprotein (a): structure, pathophysiology and clinical implications [J]. Arq Bras Cardiol, 2014, 103(1): 76-84.
[5] Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the national cholesterol education pro- gram (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment PanelⅢ) [J]. JAMA, 2001, 285(19): 2486-2497.
[6] 2014年中国胆固醇教育计划血脂异常防治建议专家组, 中华心血管病杂志编辑委员会,血脂与动脉粥样硬化循 证工作组,中华医学会心血管病学分会流行病学组. 2014年中国胆固醇教育计划血脂异常防治专家建议[J]. 全科医学临床与教育,2015,(1):3-5,10.
[7] 周良辅. 现代神经外科学[M]. 复旦大学出版社,2015. 1015-1016.
[8] Bilt IA, Hasn D, Vandertop WP, et al. Impact of cardiac complications on outcome after aneurysmal subarachnoid hemorrhage [J]. Neurology, 2009, 22(7): 635-642.
[9] 屠传建,柳建生,宋大刚,等. 经颅多普勒对外伤性脑血管 痉挛的诊断价值 [J]. 中华创伤杂志,2011,27(3):221- 223.
[10] Tewari M, Aggarwal A, Mathuriya S, et al. The outcome after aneurysmal sub arachnoid hemorrhage: a study of various factors [J]. Ann Neurosci, 2015, 22(2): 78-80.
[11] Sandvei MS, Lindekleiv H, Romundstad PR, et al. Risk factors for aneurysmal subarachnoid hemorrhage-BMI and serum lipids: 11-year follow-up of the HUNT and the Troms Study in Norway [J]. Acta Neurol Scand, 2012, 125 (6): 382-388.
[12] Tokuda Y, Stein GH. Serum lipids as protective factors for subarachnoid hemorrhage [J]. J Clin Neurosci, 2005, 12(5): 538-541.
[13] Tseng MY, Hutchinson PJ, Turner CL, et al. Biological effects of acute pravastatin treatment in patients after aneu- rysmal subarachnoid hemorrhage: a double-blind, placebo- controlled trial [J]. J Neurosurg, 2007, 107(6): 1092-1100.
[14] 余 秀. 阿托伐他汀防治蛛网膜下腔出血后脑血管痉挛 的临床观察[J]. 现代实用医学,2010,22(11): 1267- 1268.
[15] Sivashanmugam D, Ashish A, Anirudh S, et al. Serum lipid profile spectrum and delayed cerebral ischemia following subarachnoid hemorrhage: is there a relation [J]? Surg Neuro Intern, 2015, 6(22): S543-S548.
[16] Neeraj B, David S, Amanda C, et al. Free Fatty acids and delayed cerebral ischemia after subarachnoid hemorrhage [J]. Stroke, 2012, 43(3): 691-696.
[17] 向定成,张金霞,阮云军,等. 冠状动脉痉挛患者血脂与血 管内皮功能的相关性研究[J]. 中国循环杂志,2006,21 (4):270-272.
[18] 吴 恳. 脑卒中患者急性期血糖、血脂浓度检测的意义 [J]. 心血管康复医学杂志,2008,17(6):544-546.
[19] 肖健青,佘杏军. 动脉粥样硬化性脑梗死患者血脂分析 [J]. 中国现代医学杂志,2006,16(22):3495-3496.
[20] Al-Tamimi YZ, Orsi NM, Quinn AC, et al. A review of de- layed ischemic neurologic deficit following aneurysmal sub- arachnoid hemorrhage: historical overview, current treat- ment, and pathophysiology [J]. World Neurosurg, 2010, 73(6): 654-67.

相似文献/References:

[1]李朝晖 王玉贵 张孟超 综述 赵兴利 审校.CT灌注成像在动脉瘤性蛛网膜下腔出血中的 临床应用进展[J].中国临床神经外科杂志,2016,(05):313.[doi:10.13798/j.issn.1009-153X.2016.05.021]
[2]郭 芳 张 铭 李中振 梁恩和.动脉瘤性蛛网膜下腔出血后分流依赖性脑积水的危险因素分析[J].中国临床神经外科杂志,2016,(02):73.[doi:10.13798/j.issn.1009-153X.2016.02.004]
 GUO Fang,ZHANG Ming,LI Zhong-zhen,et al.Risk factors related to shunt-dependent hydrocephalus in patients with aneurysmal subarachnoid hemorrhage[J].,2016,(11):73.[doi:10.13798/j.issn.1009-153X.2016.02.004]
[3]邹志鹏 杨 海 夏军勇 张化明 张 华 魏 恒 马江红.行血管内治疗的高龄颅内动脉瘤患者脑血管痉挛的临床分析[J].中国临床神经外科杂志,2015,(07):401.[doi:10.13798/j.issn.1009-153X.2015.07.006]
 ZOU Zhi-peng,YANG Hai,XIA Jun-yong,et al.Clinical analysis of symptomatic cerebral vasospasm after endovascular treatment of ruptured cerebral aneurysms in patients of 70 and over 70 years[J].,2015,(11):401.[doi:10.13798/j.issn.1009-153X.2015.07.006]
[4]郎胜坤 许厚银 董月青 马铁柱 孙 艳 郝芊芊 王慧敏.磁共振灌注成像评估蛛网膜下腔出血后脑血管痉挛的价值[J].中国临床神经外科杂志,2016,(09):517.[doi:10.13798/j.issn.1009-153X.2016.09.002]
 LANG Sheng-kuan,XU Hou-yin,DONG Yue-qing,et al.Evaluation of cerebral vasospasm after aneurysmal subarachnoid hemorrhage by magnetic resonance perfusion weighted imaging[J].,2016,(11):517.[doi:10.13798/j.issn.1009-153X.2016.09.002]
[5]潘逸珩 雷军荣 段 波 魏德胜 陈 亮 陈志明 秦 军.动脉瘤性蛛网膜下腔出血术后脑梗死的临床特点及其发生的危险因素分析[J].中国临床神经外科杂志,2017,(01):4.[doi:10.13798/j.issn.1009-153X.2017.01.002]
 PAN Yi-heng,LEI Jun-rong,DUAN Bo,et al.Analysis of clinical features of postoperative cerebral infarction and the factors related to it in patients with aneurysmal subarachnoid hemorrhage[J].,2017,(11):4.[doi:10.13798/j.issn.1009-153X.2017.01.002]
[6]谢 飞 陈志远 曾家良 叶勇强.DSA联合血清SICAM-1评估颅内破裂动脉瘤术后脑血管痉挛的效果[J].中国临床神经外科杂志,2017,(09):617.[doi:10.13798/j.issn.1009-153X.2017.09.003]
 XIE Fei CHEN Zhi-yuan ZENG Jia-liang,Ye Yong-qiang.Application of DSA combined with serum SICAM-1 to the evaluation of cerebral vasospasm after SAH due to aneurysmal rupture[J].,2017,(11):617.[doi:10.13798/j.issn.1009-153X.2017.09.003]
[7]阮 东 王 芳 郭丽蕊 彭红梅 陈谦学 刘宝辉.C-反应蛋白与动脉瘤性蛛网膜下腔出血临床预后的关系[J].中国临床神经外科杂志,2017,(09):626.[doi:10.13798/j.issn.1009-153X.2017.09.006]
 RUAN Dong,WANG Fang,GUO Li-rui,et al.Relationship between serum level of C-reactive protein and prognoses in patients with aneurysmal subarachnoid hemorrhage[J].,2017,(11):626.[doi:10.13798/j.issn.1009-153X.2017.09.006]
[8]阿库布千、李祥龙、罗 鑫、周 江、李 昊、刘 亮、 陈礼刚、夏祥国.亚洲人群动脉瘤性蛛网膜下腔出血高压氧辅助治疗疗效的Meta分析[J].中国临床神经外科杂志,2017,(11):757.[doi:10.13798/j.issn.1009-153X.2017.11.008]
 AKU Bu-qian,LI Xiang-long,LUO Xin,et al.Meta-analysis of effects of hyperbaric oxygen therapy on clinical outcomes in Asian patients with aneurysmal subarachnoid hemorrhage[J].,2017,(11):757.[doi:10.13798/j.issn.1009-153X.2017.11.008]
[9]张 兰 库洪彬 王 敏 周 燕.动脉瘤性蛛网膜下腔出血病人血清sLOX-1、netrin-1水平变化及其与病人预后的关系[J].中国临床神经外科杂志,2020,(06):377.[doi:10.13798/j.issn.1009-153X.2020.06.013]
 ZHANG Lan,KU Hong-bin,WANG Min,et al.Relationship between serum levels of sLOX-1 and netrin-1 and progosis of patients with aneurysmal subarachnoid hemorrhage[J].,2020,(11):377.[doi:10.13798/j.issn.1009-153X.2020.06.013]
[10]李兵兵 洪景芳 李克磊 张 灏 张尚明 王守森.动脉瘤性蛛网膜下腔出血对脑静脉循环的影响[J].中国临床神经外科杂志,2021,26(01):17.[doi:10.13798/j.issn.1009-153X.2021.01.006]
 LI Bing-bing,HONG Jing-fang,LI Ke-lei,et al.Effects of aneurysmal subarachnoid hemorrhage on cerebral venous circulation[J].,2021,26(11):17.[doi:10.13798/j.issn.1009-153X.2021.01.006]
[11]姜海洋,陈虎,郭星,等.动脉瘤性蛛网膜下腔出血病人Lindegaard比值与脑组织氧分压的相关性[J].中国临床神经外科杂志,2022,27(08):640.[doi:10.13798/j.issn.1009-153X.2022.08.005]
 JIANG Hai-yang,CHEN Hu,GUO Xing,et al.Relationship between Lindegaard ratio and brain tissue oxygen tension in patients with aneurysmal subarachnoid hemorrhage[J].,2022,27(11):640.[doi:10.13798/j.issn.1009-153X.2022.08.005]
[12]付宏亮,景文记,卢俊义.血清miR-149-3p和CXCR3水平与aSAH后迟发性脑缺血的相关性分析[J].中国临床神经外科杂志,2023,28(01):11.[doi:10.13798/j.issn.1009-153X.2023.01.004]
 FU Hong-liang,JING Wen-ji,LU Jun-yi.Correlation of serum levels of miR-149-3p and CXCR3 with delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage[J].,2023,28(11):11.[doi:10.13798/j.issn.1009-153X.2023.01.004]

备注/Memo

备注/Memo:
基金项目:国家科技支撑计划(2013BAI05B05)
通讯作者:王业忠,E-mail:Wangyezhong2008@126.com
更新日期/Last Update: 2016-11-25