Can admission lipoprotein-associated phospholipase A2 predict the symptomatic cerebral vasospasm following aneurysmal subarachnoid hemorrhage?

• 作者: Cai Han-Pei Chen Xiao-Yong Ding Chen-Yu Kang De-Zhi Lin Yuan-Xiang Lin Zhang-Ya Wang Fang-Yu Yu Liang-Hong Zheng Shu-Fa
• 来源期刊: 中华神经外科杂志（英文）
• 关键词: Aneurysmal subarachnoid hemorrhage Vasospasm Biological markers
• 年，卷（期）: 2020,（4）
• 所属期刊栏目: Research
• 页码范围: 196-203
• 页数: 8页
• 语种: 中文
• DOI: 10.1186/s41016-020-00188-z

摘要

Background::Inflammation has been believed to be related to the development of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (aSAH). A potential biomarker for vascular inflammation that is well recognized is the lipoprotein-associated phospholipase A2 (Lp-PLA2). However, whether Lp-PLA2 can predict the occurrence of symptomatic cerebral vasospasm (SCV) in aSAH patients is still unknown. Thus, this study aimed to assess the value of Lp-PLA2 for predicting SCV in patients with aSAH.Methods::Between March 2017 and April 2018, we evaluated 128 consecutive aSAH patients who were admitted in the First Affiliated Hospital of Fujian Medical University. Their Lp-PLA2 level was obtained within 24 h of the initial bleeding. Factors might be related to SCV were analyzed.Results::Compared to patients without SCV, those with SCV (9.4%, 12/128) had significantly higher Lp-PLA2 level. Multivariate logistic analysis revealed that worse modified Fisher grade (OR = 10.08, 95% CI = 2.04-49.86, P = 0.005) and higher Lp-PLA2 level (OR = 6.66, 95% CI = 1.33-3.30, P = 0.021) were significantly associated with SCV, even after adjustment for confounders. Based on the best threshold, Lp-PLA2 had a sensitivity of 83.3% and a specificity of 51.7% for predicting SCV, as shown by the receiver operating characteristic curve analysis. In the poor World Federation of Neurosurgical Societies grade patient sub-group, patients with Lp-PLA2 > 200 μg/L had significantly higher SCV rate than that of patients having Lp-PLA2 ≤ 200 μg/L. Conclusion::The admission Lp-PLA2 level might be a helpful predictor for SCV in aSAH.