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首页> 外文期刊>Neurosurgery >Early plasma complement C3a levels correlate with functional outcome after aneurysmal subarachnoid hemorrhage.
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Early plasma complement C3a levels correlate with functional outcome after aneurysmal subarachnoid hemorrhage.

机译：早期血浆补体C3a水平与动脉瘤性蛛网膜下腔出血后的功能预后相关。

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OBJECTIVE: Studies have documented an inflammatory response in the circulating plasma and cerebrospinal fluid of patients with aneurysmal subarachnoid hemorrhage (aSAH). In particular, early upregulation of several complement proteins, including C3a, C4a, and C5b-9, has been demonstrated after the initial hemorrhagic insult. The inflammatory actions of the complement cascade are largely mediated through the anaphylatoxins, C3a and C5a. Recent investigations have established a critical role for C3a in the pathogenesis of cerebral ischemia. We attempt to confirm that plasma C3a and C5a values are elevated in patients with aSAH and to determine whether or not these levels are reliable independent predictors of functional outcome irrespective of clinical presentation. METHODS: Fifty-two patients with aSAH were prospectively enrolled and stratified according to admission Hunt and Hess grade, demographic variables, and functional status at the time of discharge (modified Rankin Scale score). Plasma C3a and C5a levels were determined at early and late time points after aSAH through enzyme-linked immunosorbent assay. RESULTS: After aSAH, early C3a and C5a values were increased compared with levels in non-SAH control patients (P < 0.001). Univariate analysis demonstrated that elevations in early C3a (P = 0.010) and C5a (P = 0.041) levels and poor admission Hunt and Hess grade (P = 0.015) correlated significantly with unfavorable outcome. In our multivariate model, only early C3a levels retained a strong correlation with outcome when modeled with Hunt and Hess grade (P = 0.009). CONCLUSION: These results demonstrate an association between early complement C3a levels and outcome after aSAH that seems to be independent of the initial hemorrhage. The findings suggest that inflammatory processes involving C3a may contribute to delayed morbidity and mortality after aneurysmal rupture.
机译：目的：研究表明，患有动脉瘤性蛛网膜下腔出血（aSAH）的患者血浆和脑脊液中存在炎症反应。特别是，在最初的出血性损伤后，已经证明了几种补体蛋白（包括C3a，C4a和C5b-9）的早期上调。补体级联的炎性作用主要通过过敏毒素C3a和C5a介导。最近的研究已确定C3a在脑缺血的发病机制中起关键作用。我们试图确认aSAH患者的血浆C3a和C5a值升高，并确定这些水平是否是功能预后的可靠独立预测因子，而与临床表现无关。方法：根据入院时Hunt和Hess等级，人口统计学变量和出院时的功能状态（改良的Rankin量表评分）对52例aSAH患者进行前瞻性入组和分层。通过酶联免疫吸附测定在aSAH后的早期和晚期时间点测定血浆C3a和C5a水平。结果：aSAH后，早期C3a和C5a值较非SAH对照组患者升高（P <0.001）。单因素分析表明，早期C3a（P = 0.010）和C5a（P = 0.041）水平升高以及入院Hunt和Hess成绩差（P = 0.015）与不良结局显着相关。在我们的多变量模型中，当使用Hunt和Hess分级建模时，只有早期C3a水平与结果保持强相关性（P = 0.009）。结论：这些结果表明早期补体C3a水平与aSAH后的预后之间存在关联，这似乎与最初的出血无关。这些发现表明，涉及C3a的炎症过程可能导致动脉瘤破裂后发病率和死亡率的延迟。

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