[1]陈华轩　张　渊　王　林　宋旭东　刘　毅　范润金.缺血修饰白蛋白对动脉瘤性蛛网膜下腔出血后脑血管痉挛的评估价值[J].中国临床神经外科杂志,2019,(01):26-28.[doi:10.13798/j.issn.1009-153X.2019.01.007]
　CHEN Hua-xuan,ZHANG Yuan,WANG Lin,et al.Value of ischemia-modified albumin to assesment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage[J].,2019,(01):26-28.[doi:10.13798/j.issn.1009-153X.2019.01.007]
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缺血修饰白蛋白对动脉瘤性蛛网膜下腔出血后 脑血管痉挛的评估价值()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年01期
页码:
26-28
栏目:
论著
出版日期:
2019-01-25

文章信息/Info

Title:
Value of ischemia-modified albumin to assesment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage
文章编号:
1009-153X（2019）01-0026-03
作者:
陈华轩　张　渊　王　林　宋旭东　刘　毅　范润金
Author(s):
CHEN Hua-xuan;  ZHANG Yuan;  WANG Lin;  SONG Xu-dong;  LIU Yi;  FAN Run-jin.
Department of Neurosurgery, Nanchong Municipal Central Hospital, Nanchong 637000, China
关键词:
颅内动脉瘤; 蛛网膜下腔出血; 脑血管痉挛; 缺血修饰白蛋白; 预后
Keywords:
Aneurysmal subarachnoid hemorrhage;  Cerebral vasospasm;  Ischemia-modified albumin;  Prognosis
分类号:
R743.9
DOI:
10.13798/j.issn.1009-153X.2019.01.007
文献标志码:
A
摘要:
目的 探讨缺血修饰白蛋白（IMA）对动脉瘤性蛛网膜下腔出血（aSAH）后脑血管痉挛的评估价值及其与病人预后的关系。方法 回顾性分析2015年6月至2017年6月收治的198例aSAH的临床资料。入院后14 d内每天应用血清白蛋白钴结合（ACB）试剂盒检测血清IMA水平，ACB值越低表示IMA水平越高；同时，使用经颅多普勒监测大脑中动脉平均血流速度（Vm）评估脑血管痉挛（CVS），其中120~140 cm/s为轻度，141~200 cm/s为中度，>200 cm/s为重度。结果 发病14 d内，Vm先增高（P<0.05），后降低（P<0.05），7~10 d达峰值；ACB值先降低（P<0.05），后增高（P<0.05），7~10 d最低。随改良Fisher分级增高，CVS发生率明显增高（P<0.05），ACB值明显降低（P<0.05）。发病6个月，预后不良（GOS评分1~3分）69例，预后良好（GOS评分4~5分）129例；预后不良组ACB值[（42.76±5.63）U/ml]明显低于预后良好组[（61.18±5.91）U/ml；P<0.01]。结论 血清IMA水平能反映aSAH后脑缺血情况，与CVS严重程度呈正相关，对CVS的评估有重要价值；并且血清IMA可辅助判断预后。
Abstract:
Objective To investigate the value of ischemia-modified albumin (IMA) to the asessment of the cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (aSAH) and the relationship between the serum level of IMA and the prognosis in the patients with aSAH. Methods The clinical data of 198 patients with aSAH were analyzed retrospectively. The serum levels albumin cobalt binding (ACB) which indirectly reflected the serum levels of IMA were detected in all the patients, in whom the mean blood flow velocity (Vm) of middle cerebral artery (MCA) was determined by transcranial doppler 2~14 days after aSAH. Results Vm of MCA reached the peak 7~10 days after aSAH and then gradually decreased. The change in the serum levels of ACB was opposite to that in Vm of MCA. Vm of MCA was significantly higher 7~10 days after aSAH than that 2~6 days after aSAH (P<0.05), which was significantly higher than that 11~14 days after aSAH (P<0.05). The serum levels of ACB were significantly higher 11~14 days after aSAH than those 2~6 days after aSAH (P<0.05), which were significantly higher than that 7~10 days after aSAH (P<0.05). The higher the modified Fisher grade was, the higher the incidence of CVS was and the lower the serum level of ACB was (P<0.05). The serum level of ACB [(61.18±5.91)U/ml] was significantly higher in the patients with good prognosis than that [(42.76±5.63)U/ml] in the patients with bad prognosis (P<0.05). Conclusions The serum level of ACB which is negatively correlated with the severity of CVS can be used to assess the degree of the CVS and prognosis in the patients with aSAH.

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备注/Memo

备注/Memo:
doi:10.13798/j.issn.1009-153X.2019.01.007 作者单位：637000 四川，南充市中心医院神经外科（陈华轩、张　渊、王　林、宋旭东、刘　毅、范润金）
更新日期/Last Update: 2019-01-25