动脉瘤性蛛网膜下腔出血患者脑脊液、血清正五聚蛋白3和C反应蛋白的表达水平及临床意义

Expression and Clinical Significance of Serum N-pentamerin 3 and C-reactive Protein in Cerebrospinal Fluid and Serum of Patients with Aneurysmal Subarachnoid Hemorrhage

目的检测动脉瘤性蛛网膜下腔出血(aSAH)患者血管介入栓塞术后24 h内脑脊液及血清中正五聚蛋白3(PTX3)、C反应蛋白(CRP)的水平,为病情程度和预后评估提供参考。方法选取2019年9月—2021年3月接受血管介入栓塞术治疗的aSAH 55例,所有患者于术后24 h内采集脑脊液及血清,采集同期行椎管内麻醉的其他疾病患者20例的脑脊液及健康体检者30例的血清,检测PTX3和CRP水平。根据世界神经外科联盟委员会(WFNS)分级及改良Rankin评分(mRS)将aSAH患者分为不同病情和不同预后组。分析不同病情、不同预后组患者脑脊液及血清中PTX3、CRP水平,探讨其相关性,并评估其对aSAH病情严重程度及预后的诊断价值。结果aSAH患者血清中PTX3、CRP水平均高于健康体检者(P<0.01)。WFNS分级不良组脑脊液及血清中PTX3、CRP水平均高于分级良好组(P<0.01)。联合检测脑脊液及血清中PTX3、CRP水平对aSAH病情严重程度更具诊断价值(P<0.05)。mRS评分预后不良组脑脊液及血清中PTX3和CRP水平均高于预后良好组(P<0.01)。联合检测脑脊液及血清中PTX3、CRP水平对aSAH预后预测价值更高(P<0.05)。脑脊液中PTX3水平与脑脊液中CRP、血清中PTX3水平呈正相关性(r=0.390、0.300,P<0.05,P<0.01),与血清中CRP水平无明显相关性(r=0.111,P>0.05)。结论aSAH患者血管介入栓塞术后24 h内脑脊液及血清中PTX3、CRP水平对患者病情程度及预后评估具有潜在价值。

Objective To detect the level of serum n-pentamerin 3(PTX3)and C-reactive protein(CRP)in cerebrospinal fluid(CSF)and serum within 24 h after intravascular interventional embolization in patients with aneurysmal subarachnoid hemorrhage(aSAH),so as to provide reference for evaluation of disease severity and prognosis.Methods A total of 55 aSAH patients who underwent endovascular interventional embolization from September 2019 to March 2021 were selected.CSF and serum of all patients were collected within 24 h after surgery,and CSF of 20 patients with other diseases who underwent intraspinal anesthesia during the same period and serum of 30 healthy subjects were collected.The levels of PTX3 and CRP were detected.According to World Federation of Neurosurgery(WFNS)classification and modified Rankin score(mRS),aSAH patients were divided into different conditions and different prognostic groups.The levels of PTX3 and CRP in CSF and serum of patients with different conditions and different prognosis groups were analyzed to explore their correlation,and to evaluate their diagnostic value for the severity and prognosis of aSAH.Results The levels of PTX3 and CRP in serum of aSAH patients were higher than those of healthy subjects(P<0.01).The levels of PTX3 and CRP in CSF and serum of poor WFNS classification group were higher than those of good WFNS classification group(P<0.01).Combined detection of PTX3 and CRP levels in CSF and serum had more diagnostic value for the severity of aSAH(P<0.05).The levels of PTX3 and CRP in CSF and serum of the poor prognosis group by mRS were higher than those of the good prognosis group(P<0.01).Combined detection of PTX3 and CRP levels in CSF and serum had higher prognostic value for aSAH(P<0.05).PTX3 level in CSF was positively correlated with CRP level in CSF and PTX3 in serum(r=0.390,0.300,P<0.05,P<0.01),but had no significant correlation with CRP level in serum(r=0.111,P>0.05).Conclusion The levels of PTX3 and CRP in CSF and serum of patients with aSAH within 24 h after intravascular interventional embolization have potential value in diagnosing the severity and prognosis of the patients.