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首页> 外文期刊>European journal of neurology: the official journal of the European Federation of Neurological Societies >Optimizing blood pigment analysis in cerebrospinal fluid for the diagnosis of subarachnoid haemorrhage - a practical approach
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Optimizing blood pigment analysis in cerebrospinal fluid for the diagnosis of subarachnoid haemorrhage - a practical approach

机译：优化脑脊液中的血色素分析以诊断蛛网膜下腔出血-一种实用方法

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Background: Patients presenting with sudden severe headache may have a subarachnoid haemorrhage (SAH). After a normal head computer tomography (CT), a lumbar puncture is routinely performed to rule out SAH. Photospectrometry is then used to detect bilirubin in cerebrospinal fluid (CSF). Photospectrometric analysis of CSF reaches a high sensitivity, but a low specificity for SAH. This low specificity necessitates extensive additional research to rule out cerebral aneurysm accompanied by high costs and risk of complications. Objective: The objective of this study was to retrospectively evaluate two different CSF interpretation methods using photospectrometry in patients presenting with acute headache. The first of these is the Leiden method, an iterative model using a standard calculation. The second is the UK NEQAS guideline, which uses the original spectrum in combination with a decision tree. Our goal was to obtain retrospective data on patients screened with both methods to improve specificity of CSF research. Results: We included 361 patients in this study; 47 of these had a raised bilirubin concentration in the CSF according to the Leiden method. In only nine of these 47 patients was an aneurysm found; in the other patients the Leiden test was positive for other reasons (viral meningitis, hyperbilirubinaemia, etc.). Of the 47 patients with raised bilirubin, 24 could be re-evaluated using the UK NEQAS. Of these 24 patients, five had an aneurysm. No aneurysms were found in patients with a negative result according to the UK NEQAS guideline. Conclusion: Our data show that a raised bilirubin calculated using the Leiden method seems to have a lower specificity than the UK NEQAS guideline. For practical reasons, it seems advantageous to use the Leiden method as a screening method and use the UK NEQAS guideline if a positive result is found.
机译：背景：突然严重头痛的患者可能会出现蛛网膜下腔出血（SAH）。在正常的头部计算机断层扫描（CT）之后，常规进行腰穿以排除SAH。然后使用光谱法检测脑脊液（CSF）中的胆红素。 CSF的光谱分析可以达到很高的灵敏度，但对SAH的特异性却很低。这种低特异性需要广泛的附加研究来排除伴有高成本和并发症风险的脑动脉瘤。目的：本研究的目的是回顾性评估使用光谱法对急性头痛患者的两种不同的脑脊液解释方法。首先是莱顿方法，这是一种使用标准计算的迭代模型。第二个是英国NEQAS指南，该指南结合了原始频谱和决策树。我们的目标是获取两种方法筛查的患者的回顾性数据，以提高CSF研究的特异性。结果：我们纳入了361例患者。根据Leiden方法，其中47例的CSF中胆红素浓度升高。在这47名患者中，只有9名发现动脉瘤。在其他患者中，莱顿测试因其他原因（病毒性脑膜炎，高胆红素血症等）呈阳性。在47例胆红素升高的患者中，有24例可以使用UK NEQAS进行重新评估。在这24名患者中，有5名患有动脉瘤。根据英国NEQAS指南，未发现阴性结果的动脉瘤。结论：我们的数据表明，使用莱顿法计算的胆红素升高似乎比英国NEQAS指南的特异性低。出于实际原因，如果发现阳性结果，使用莱顿方法作为筛选方法并使用英国NEQAS指南似乎是有利的。

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