Dickkopf-1在动脉瘤性蛛网膜下腔出血预后中的价值

目的探讨Dickkopf-1水平与aSAH临床预后的相关性。方法采用酶联免疫吸附试验检测132例蛛网膜下腔出血(aSAH)患者和100例正常对照者血清Dickkopf-1水平。评估患者的基本特征,世界神经外科医师联盟评分(WFNS)和改良Fisher分级。通过3个月随访记录患者格拉斯哥预后评分(GOS)。建立多变量Logistic回归模型,分析血清Dickkopf-1水平与预后的相关性。结果与对照组比较,aSAH后血清Dickkopf-1水平显著升高(P<0.05)。Dickkopf-1水平与WFNS评分和改良Fisher评分高度相关(P<0.05)。预后不良患者Dickkopf-l水平显著升高(P<0.05)。多变量Logistic回归分析显示,血清Dickkopf-1是不良预后的独立预测因子(P<0.05)。ROC曲线分析显示,血清Dickkopf-1水平可有效预测不良预后,结论血清Dickkopf-1水平与aSAH的严重程度和不良预后密切相关,血清Dickkopf-l可能是预测aSAH不良预后的新生物标志物。

Objective To investigate the relationship between Dickkopf-1 levels and clinical prognosis of aSAH.Methods Serum Dickkopf-1 levek were determined in 132 aneurysmal subarachnoid hemorrhage(aSAH)patients and 100 control individuals using the enzyme-linked immunosorbent assay,patients'characteristics were assessed by the World Federation of Neurological Surgeons(WFNS)Scale and modified Fisher grade.At 3-month followup,Glasgow Outcome Scale(GOS)was recorded.The multivariate Logistic regression model was constructed to discern the associarion of serum Dickkopf-1 levels with prognosis.Results Compared with control group,serum Dickkopf-1 levels were substantially raised after aSAH(P<0.05).Dickkopf-1 levels were highly related to WFNS score and modified Fisher score(P<0.05).Patients with a poor prognosis had significantly increased Dickkopf-1 levels(P<0.05).Multivariate Logistic regression analysis showed that serum Dickkopf-1 appeared as an independent predictor of poor prognosis(P<0.05).ROC curve analysis showed that serum Dickkopf-1 levels predicted poor prognosis efBciendy.Conclusion Serum Dickkopf-1 levels are strongly associated with the severity and poor prognosis of aSAH,suggesting that serum dickkopf-l may be a novel biomarker for predicting poor prognosis in aSAH.