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首页> 外文期刊>Neurocritical care >Serum Alkaline Phosphatase Level is Associated with Angiographic Vasospasm, Delayed Cerebral Ischemia-Caused Clinical Deterioration, and Functional Outcome After Aneurysmal Subarachnoid Hemorrhage
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Serum Alkaline Phosphatase Level is Associated with Angiographic Vasospasm, Delayed Cerebral Ischemia-Caused Clinical Deterioration, and Functional Outcome After Aneurysmal Subarachnoid Hemorrhage

机译：血清碱性磷酸酶水平与血管造影血管痉挛有关，延迟脑缺血引起的临床恶化，动脉瘤蛛网膜瘤出血后的功能结果

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摘要

Background Alkaline phosphatase (ALP) has been implicated to be associated with poor outcome in ischemic stroke patients, yet its role in aneurysmal subarachnoid hemorrhage (aSAH) patients is unknown. The current study aimed to investigate the on-admission and short-term variation trend of ALP levels in aSAH patients as well as its associations with vasospasm, delayed cerebral ischemia (DCI), and outcome after aSAH. Methods Between January 2014 and May 2018, all consecutive aSAH patients were prospectively enrolled. Blood samples from patients and 78 healthy individuals were obtained. Baseline information, clinical data, and radiologic data were collected, and serum ALP levels during hospitalization were measured. Patients were followed up for 6 months. Results One hundred and ninety-six aSAH patients were included. The serum ALP levels in aSAH patients were significantly higher compared to controls (71 vs. 61 U/L, p = 0.0002), yet did not differ significantly between patients with severe (WFNS 4-5) and mild clinical condition (72 vs. 63 U/L, p = 0.3362). However, ALP was significantly higher in patients with severe radiologic status (modified Fisher 3-4) compared to those with mild radiologic status (77 vs. 61.5 U/L, p = 0.0005). A significant correlation emerged between modified Fisher score and ALP level (r = 0.246, p = 0.001). Multivariable analysis found that higher ALP level was associated with angiographic vasospasm (OR 1.019, 95% CI 1.002-1.036, p = 0.026) and DCI-caused clinical deterioration (OR 1.019, 95% CI 1.001-1.037, p = 0.037), while higher WFNS score, modified Fisher score, and ALP level were independently associated with unfavorable outcome (serum ALP level, OR 1.083, 95% CI 1.041-1.127, p < 0.001). Trend analysis of ALP level based on 103 patients' data revealed a significant decrease in ALP level on post-admission day 7-9 (median; on-admission day vs. post-admission day 7-9, 72 vs. 60 U/L, p = 0.0012; post-admission day 3-5 vs. day 7-9, 70 vs. 60 U/L, p = 0.0052) and subsequent increase in ALP level on post-admission day 12-14 (median, 84 U/L, p < 0.0001). Higher ALP levels were observed in patients with unfavorable outcome on on-admission day, post-admission day 3-5, and 12-14 (median; unfavorable vs. favorable; on-admission day, 86 vs. 67 U/L, p = 0.0122; post-admission day 3-5, 80 vs. 64 U/L, p = 0.0044; post-admission day 7-9, 75 vs. 53.5 U/L, p < 0.0001) but not on post-admission day 12-14. Conclusions Elevated serum ALP level is associated with vasospasm, DCI-caused clinical deterioration, and functional outcome after aSAH. Further studies are required to examine the potential role of serum ALP as an outcome predictor for aSAH patients.
机译：背景技术碱性磷酸酶（ALP）已涉及与缺血性卒中患者的差异有关，但其在动脉瘤蛛网膜瘤出血（ASAH）患者中的作用是未知的。目前的研究旨在探讨ASAH患者ALP水平的入学和短期变异趋势以及其与血管痉挛的关联，延迟脑缺血（DCI）以及ASAH后的结果。方法2014年1月至2018年5月，所有连续的Asah患者均在前招生。获得患者和78名健康个体的血液样本。收集基线信息，临床资料和放射学数据，测量住院期间的血清ALP水平。患者随访6个月。结果包括一百九十六个朝鲜患者。与对照相比，Asah患者的血清ALP水平显着更高（71 vs.61 U / L，P = 0.0002），在严重（WFNS 4-5）和轻度临床状况（72 Vs.）之间没有显着差异63 U / L，P = 0.3362）。然而，与具有轻度放射病理状态的患者（修饰的FIRER 3-4）的患者患者，ALP显着高（77 Vs.61.5 U / L，P = 0.0005）。改性Fisher评分和ALP水平之间出现的显着相关性（r = 0.246，p = 0.001）。多变量分析发现，较高的ALP水平与血管造影血管痉挛（或1.019,95％CI 1.002-1.036，P = 0.026）和DCI引起的临床劣化（或1.019,95％CI 1.001-1.037，P = 0.037）相关联较高的WFNS评分，改性Fisher评分和ALP水平与不利的结果（血清ALP水平或1.083,95％CI 1.041-1.127，P <0.001）独立相关。基于103名患者数据的ALP水平趋势分析显示，入院后第7-9天的ALP水平显着降低（中位数;入场日与入场前的第7-9天，72与60 U / L. ，p = 0.0012;入院后第3-5天和第7-9,70〜60 u / l，p = 0.0052），并随后在入院后第12-14天的ALP水平增加（中位数，84 u / L，P <0.0001）。在入院日的不利结果的患者中观察到较高的ALP水平，入院后第3-5天和12-14天（中位数;不利的与有利;入场日，86 vs. 67 U / L，P = 0.0122;入院后第3-5天，80〜64 U / L，p = 0.0044;入院后第7-9天，75节，53.5 U / L，P <0.0001）但不在入院后日12-14。结论血清ALP水平升高与血管痉挛有关，DCI导致临床劣化和ASAH后的功能结果。需要进一步的研究来检查血清ALP作为ASAH患者的结果预测因子的潜在作用。

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  • 来源
    《Neurocritical care》 |2019年第3期|共10页
  • 作者

    Zhu Yu; Jiang Hao; Li Yongda; Weng Yuxiang; Xu Kangli; Zhou Lei; Lin Hongwei; Sun Tianfu; Cheng Dexin; Shen Jie; Zeng Jianping; Ye Di; Wang Duanbu; Zhan Renya;

  • 作者单位

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

    Zhejiang Univ Affiliated Hosp 1 Dept Neurosurg Sch Med 79 Qingchun Rd Hangzhou Zhejiang;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 神经病学与精神病学;
  • 关键词

    Alkaline phosphatase; Angiographic vasospasm; Delayed cerebral ischemia; Outcome; Aneurysmal subarachnoid hemorrhage;

    机译：碱性磷酸酶;血管造影血管痉挛;延迟脑缺血;结果;动脉瘤蛛网膜瘤出血;

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