血清ET-1水平与动脉瘤性蛛网膜下腔出血后迟发性脑缺血的关系

Relationship between serum ET-1 level and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

目的探讨血清内皮素-1(ET-1)水平对动脉瘤性蛛网膜下腔出血(aSAH)后迟发性脑缺血(DCI)的预测效能。方法回顾性分析2019年9月至2023年1月收治的104例aSAH的临床资料。DCI定义为在排除手术相关脑缺血后,第3~14天出现CT低密度或相应的MRI表现。采用ELISA法检测入院时血清ET-1水平。结果104例中,39例(37.50%)发生DCI。多因素logistics回归分析显示血清ET-1水平增高为DCI的独立危险因素(OR=9.784;95%CI 3.458~27.688;P<0.001)。ROC曲线分析显示,血清ET-1水平预测DCI的曲线下面积为0.840(95%CI 0.764~0.917),最佳截断值为33.25 pg/ml,灵敏度及特异度分别为79.5%、76.9%。结论aSAH后血清ET-1水平升高,监测血清ET-1水平变化,可预测DCI的发生风险。

Objective To investigate the predictive value of serum endothelin-1(ET-1)level in delayed cerebral ischemia(DCI)after aneurysmal subarachnoid hemorrhage(aSAH).Methods The clinical data of 104 patients with aSAH who were admitted to our hospital from September 2019 to January 2023 were retrospectively analyzed.DCI was defined as the presence of low CT density or corresponding MRI findings on days 3 to 14 after the exclusion of surgery-related cerebral ischemia.The serum ET-1 level was detected by ELISA.Results Of 104 patients,39 patient(37.50%)had DCI.Multivariate logistic regression analysis showed that increased serum ET-1 level was an independent risk factor for DCI(OR=9.784;95%CI 3.458-27.688;P<0.001).ROC curve analysis showed that the area under the curve of serum ET-1 level to predict DCI was 0.840(95%CI 0.764~0.917),the cutoff value was 33.25 pg/ml,and the sensitivity and specificity were 79.5%and 76.9%,respectively.Conclusions Serum ET-1 level increases after aSAH,monitoring the change of serum ET-1 level can predict the risk of DCI.