中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2017, Vol. 12 ›› Issue (12): 2014-2020.doi: 10.4103/1673-5374.221158

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

 
D-二聚体可以预测动脉瘤性蛛网膜下腔出血患者的预后：回顾性研究

  

  • 收稿日期:2017-10-27 出版日期:2017-12-15 发布日期:2017-12-15

D-dimer may predict poor outcomes in patients with aneurysmal subarachnoid hemorrhage: a retrospective study

Jun-hui Liu1, Xiang-kui Li2, Zhi-biao Chen1, Qiang Cai1, Long Wang1, Ying-hu Ye1, Qian-xue Chen1   

  1. 1 Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
    2 Department of Neurosurgery, Affiliated Hospital of Shandong Medical College, Linyi, Shandong Province, China
  • Received:2017-10-27 Online:2017-12-15 Published:2017-12-15
  • Contact: Qian-xue Chen, Ph.D.,chenqx666@sohu.com.

PDF

292

摘要：

血清标记物可能在预测动脉瘤性蛛网膜下腔出血患者预后方面可靠性较强。试验拟对动脉瘤性蛛网膜下腔出血患者入院时血清标记物与患者不良预后的关系进行回顾性分析。试验收集146例于2014-5-1至2016-3-30在武汉大学人民医院就诊动脉瘤性蛛网膜下腔出血患者，在患者发病48h内采集其血清样本，分析血清标记物表达情况，同时记录其基线信息、并发症情况以及6个月时的预后情况。单因素及多因素逻辑回归分析生物标记物与预后的关系，然后以受试者工作特征曲线探索生物标记物预测的可能。结果显示在146例患者中有102例预后情况好，另4例预后不佳。单因素及多因素逻辑回归分析结果显示，世界神经外科医师联盟分级高、血清D-二聚体水平高和神经系统并发症发生率高与较差预后显著相关，进一步受试者工作特征曲线结果证实D-二聚体与不良预后有关，且D-二聚体也与神经系统并发症的相关性强。由此说明D-二聚体是动脉瘤性蛛网膜下腔出血患者预测预后不良的独立预测因子。

orcid:0000-0003-1398-2325(Qian-xue Chen)

关键词: 神经再生, 动脉瘤性蛛网膜下腔出血, D-二聚体, 血清, 生物标志物, 并发症, 预后, Logistic回归分析

Abstract:

Serum biomarkers may play a reliable role in predicting the outcomes of patients with aneurysmal subarachnoid hemorrhage. This study retrospectively analyzed the relationship between serum biomarkers on admission and outcomes in patients with aneurysmal subarachnoid hemorrhage. We recruited 146 patients with aneurysmal subarachnoid hemorrhage who were treated in Renmin Hospital of Wuhan University of China between 1 May 2014 and 30 March 2016. There were 57 males and 89 females included and average age of included patients was 57.03 years old. Serum samples were taken immediately on admission (within 48 hours after initial hemorrhage) and the levels of serum biomarkers were detected. Baseline information, complications, and outcomes at 6 months were recorded. Univariate and multivariate logistic regression analyses were used to explore the relationship between biomarkers and clinical outcomes. Receiver operating characteristic curves were obtained to investigate the possibility of the biomarkers predicting prognosis. Of the 146 patients, 102 patients achieved good outcomes and 44 patients had poor outcomes. Univariate and multivariate analyses showed that high World Federation of Neurosurgical Societies grade, high serum D-dimer levels, and high neurological complications were significantly associated with poor outcomes. Receiver operating characteristic curves verified that D-dimer levels were associated with poor outcomes. D-dimer levels strongly correlated with neurological complications. In conclusion, we suggest that D-dimer levels are a good independent prognostic factor for poor outcomes in patients with aneurysmal subarachnoid hemorrhage.

Key words: nerve regeneration, aneurysmal subarachnoid hemorrhage, D-dimer, serum, biomarkers, complications, prognosis, logistic regression analysis, neural regeneration