An Early Increase of Blood Leukocyte Subsets in Aneurysmal Subarachnoid Hemorrhage Is Predictive of Vasospasm.
An Early Increase of Blood Leukocyte Subsets in Aneurysmal Subarachnoid Hemorrhage Is Predictive of Vasospasm.
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DOI：
10.3389/fneur.2020.587039
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发表时间：
2020
影响因子：
3.4
通讯作者：
Zona G
中科院分区：
文献类型：
--
作者：
Bacigaluppi S;Ivaldi F;Bragazzi NL;Benvenuto F;Gallo F;D'Andrea A;Severi P;Uccelli A;Zona G
目的：血管痉挛是蛛网膜下腔出血（aSAH）患者的严重并发症，无法可靠预测。其病理生理学仍然难以捉摸，目前的证据表明炎症是主要驱动力之一。本研究旨在分析aSAH伴或不伴血管痉挛患者的循环免疫细胞亚群随时间的变化。方法：我们进行了一项前瞻性观察性研究，招募自发性aSAH患者。在aSAH后第0天、第3 - 4、6 - 8、10 - 11、13 - 15和18 - 21天的预定时间点采集外周血。进行流式细胞术分析、血细胞计数以及实验室和诊断参数。通过经颅多普勒和高级成像监测患者的血管痉挛，并将其分为有（VS）和无血管痉挛VS（NVS）组。结果：共纳入42例患者进行研究分析，其中VS和NVS各21例。在随后发生血管痉挛的患者中，发现血小板、白细胞、中性粒细胞、淋巴细胞、NK淋巴细胞、单核细胞和CD 14 ++ CD 16 − DR+单核细胞计数在第0天早期显著增加。在多变量分析中，血小板、白细胞、淋巴细胞和NK淋巴细胞的早期差异仍然显著。结论：aSAH早期免疫细胞亚群的增加可能有助于预测VS。
Objective: Vasospasm is a severe complication in patients with aneurysmal subarachnoid hemorrhage (aSAH) and cannot be reliably predicted. Its pathophysiology remains elusive with the current body of evidence suggesting inflammation as one of the main driving forces. We here aimed to analyze circulating immune cell subsets over time in patients with aSAH with or without vasospasm. Methods: We performed a prospective observational study recruiting patients with spontaneous aSAH. Peripheral blood withdrawn at pre-specified time-points after aSAH, day 0, days 3–4, 6–8, 10–11, 13–15, and 18–21. Flow cytometry analysis, cell blood counts, and laboratory and diagnostic parameters were performed. Patients were monitored by transcranial Doppler for vasospasm as well as by advanced imaging and divided into a group with (VS) and without vasospasm VS (NVS). Results: We included 42 patients for study analysis, 21 VS and 21 NVS. An early significant increase at day 0 in platelet, leukocyte, neutrophil, lymphocyte, NK lymphocyte, monocyte, and CD 14++ CD16− DR+ monocyte counts was found in patients with later ensuing vasospasm. The early differences in platelets, leukocytes, lymphocytes, and NK lymphocytes remained significant on multivariate analysis. Conclusions: An early increase of immune cellular subsets in aSAH may contribute to predict VS.
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