In-hospital C-reactive protein predicts outcome after aneurysmal subarachnoid haemorrhage treated by endovascular coiling
In-hospital C-reactive protein predicts outcome after aneurysmal subarachnoid haemorrhage treated by endovascular coiling
复制标题
DOI：
10.1111/aas.12441
复制
发表时间：
2015-02-01
影响因子：
2.1
通讯作者：
Nellgard, B.
中科院分区：
文献类型：
--
作者：
Csajbok, L. Z.;Nylen, K.;Nellgard, B.
背景本研究旨在前瞻性地检查接受血管内弹簧圈栓塞治疗的动脉瘤性蛛网膜下腔出血（aSAH）患者的炎症标志物C反应蛋白（CRP）是否升高，并探讨CRP是否可以作为长期神经系统结局的预后因素。 方法这项单家医院研究包括98例连续接受血管内治疗的确诊aSAH患者。 卷绕。入院状态根据世界神经外科学会联合会 (WFNS) 量表进行分类，初始脑计算机断层扫描根据 Fisher 量表进行分类。在初次采血后第 0、1、2、3、4、6 和 8 天分析 CRP。 1年后，根据总体结果的扩展格拉斯哥结果量表（GOSE）和局灶性缺陷的美国国立卫生研究院卒中量表（NIHSS）进行神经系统随访。结果CRP值在第3-4天从正常增加到峰值53mg/l，然后在第8天下降，但没有恢复正常。CRP升高较高的患者在1年后神经系统结果较差。第一周的 CRP 与结果 (r=0.417) 和 NIHSS (r=0.449) 的相关性比初始临床状态（WFNS；r=0.280 和 0.274）和放射学（Fisher 量表；r=0.137 和 0.158）的相关性更强。 CRP 升高表明存在不良结果的风险 (GOSE) (P
BackgroundThis study aimed to examine prospectively whether the inflammatory marker C-reactive protein (CRP) increases in patients with aneurysmal subarachnoid haemorrhage (aSAH) treated by endovascular coiling and investigate whether CRP could be used as prognostic factor for long-term neurological outcome.MethodsThis single-hospital study comprised 98 consecutive patients with confirmed aSAH treated by endovascular coiling. Admission status was classified according to the World Federation of Neurosurgical Societies (WFNS) Scale and initial cerebral computed tomography according to Fisher scale. CRP was analysed on days 0, 1, 2, 3, 4, 6 and 8 after the initial bleed. A neurological follow up was performed 1 year later according to the Extended Glasgow Outcome Scale (GOSE) for overall outcome and National Institute of Health Stroke Scale (NIHSS) for focal deficit.ResultsCRP values increased from normal to peak at 53mg/l at day 3-4 and then declined, without normalising, at day 8. Patients with a higher increase in CRP had a poorer neurological outcome after 1 year. CRP during the first week had a stronger correlation to outcome (r=0.417) and NIHSS (r=0.449) than initial clinical status (WFNS; r=0.280 and 0.274) and radiology (Fisher scale; r=0.137 and 0.158). CRP increase indicated a risk of poor outcome (GOSE) (P