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首页> 外文期刊>The Egyptian Journal of Neurology, Psychiatry and Neurosurgery >Role of serum biomarkers and transcranial Doppler in predicting cerebral vasospasm after aneurysmal subarachnoid hemorrhage
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Role of serum biomarkers and transcranial Doppler in predicting cerebral vasospasm after aneurysmal subarachnoid hemorrhage

机译：血清生物标志物和经颅多普勒在动脉瘤性蛛网膜下腔后脑血管痉挛预测脑血管痉挛的作用

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Aneurysmal subarachnoid hemorrhage (aSAH) can have serious consequences related to vasospasm and delayed cerebral ischemia (DCI). Serum biomarkers have emerged as a promising assessment tool to facilitate earlier diagnosis of cerebral vasospasm (CV) and to identify pre-clinical vessel narrowing. Our aim was to detect the predictive value of serum biomarkers such as von Willebrand factor (vWF), vascular endothelial growth factor (VEGF) and matrix metalloproteinase9 (MMP-9) in CV after aSAH. Thirty five patients with recent aSAH were included. Patients were divided into two groups; 19 patients (CV group) and 16 patients (non-CV group). The CV group was further subdivided into 9 symptomatic (DCI) and 10 asymptomatic patients. All patients underwent transcranial Doppler (TCD) evaluations three times a week for 2 weeks measuring the mean flow velocities. Serum level of vWF, MMP-9, and VEGF were assessed twice (at onset and within 2 weeks). A statistically significant increase in serum biomarker levels was found in the CV group. Cutoff value for vWF, MMP-9, and VEGF were 4985 ng/ml, 495 ng/ml, and 184 pg/ml, respectively. Statistically significant positive correlations were found between serum levels of biomarkers and degree of vasospasm. No difference was found in the biomarkers between symptomatic CV and asymptomatic CV. Serum biomarkers are a reliable tool to predict CV following aSAH, their levels reflect the severity of vascular vasospasm, yet, they cannot predict DCI. TCD has a strong role in early detection, monitoring of post subarachnoid vasospasm and successfully capturing asymptomatic DCI.
机译：动脉瘤性蛛网膜下腔出血（ASAH）可以对血管痉挛和延迟脑缺血（DCI）有关的严重后果。血清生物标志物已成为一个有前途的评估工具，以促进早期诊断脑血管痉挛（CV）并鉴定临床前血管变窄。我们的目的是检测血清生物标志物的预测值，如von Willebrand因子（VWF），血管内皮生长因子（VEGF）和基质金属蛋白酶9（MMP-9）在ASAH之后。包括三十五名近期Asah患者。患者分为两组; 19名患者（CV组）和16名患者（非CV组）。 CV组进一步细分为9例症状（DCI）和10名无症状患者。所有患者均经过经颅多普勒（TCD）评价每周三次，2周测量平均流速。评估血清VWF，MMP-9和VEGF的血清水平（在发病和2周内）。在CV组中发现了血清生物标志物水平的统计学显着增加。 VWF，MMP-9和VEGF的截止值＆GT; 4985 ng / ml，＆ 495 ng / ml，和＆分别为184 pg / ml。血清生物标志物水平与血管痉挛程度之间存在统计学上显着的阳性相关性。在症状CV和无症状CV之间的生物标志物中没有发现任何差异。血清生物标志物是一种可靠的工具来预测ASAH的CV，它们的水平反映了血管血管痉挛的严重程度，但他们无法预测DCI。 TCD在早期检测中具有很强的作用，监测蛛网膜下腔血管痉挛并成功捕获无症状DCI。

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