Abstract：【Objective】To explore the influencing factors of early brain injury (EBI) in patients with high-grade aneurysmal subarachnoid hemorrhage (aSAH). 【 Methods 】 A retrospective analysis was conducted on the clinical data of 182 high-grade aSAH patients admitted to our hospital from March 2017 to March 2022. They were divided into EBI group (n=90) and non EBI group (n=92) based on the occurrence of EBI. We collected and compared baseline data from two groups of patients, and used multivariate logistic regression analysis to identify independent risk factors for EBI in high-grade aSAH patients.【Results】 The EBI group had a higher proportion of age, hyperglycemia, hypomagnesemia, hyponatremia, and Fisher's grade Ⅲ-Ⅳ than the non EBI group (P<0.05), and higher levels of serum periosteal protein, IL-6, and S100B protein than the non EBI group (P<0.05). Multivariate logistic regression analysis showed that age ≥ 60 years old, hyperglycemia, hypomagnesemia, hyponatremia, Fisher's grading (Ⅲ-Ⅳ), periosteal protein≥270.00 ng/mL, IL-6≥47.10 pg/mL, S100B protein ≥ 2.05 μg/L was an independent risk factor for EBI in high-grade aSAH patients (P<0.05).【Conclusion】 There are many risk factors for EBI in high-grade aSAH patients, which are not only related to age, hyperglycemia, hypomagnesemia, hyponatremia, and Fisher's grading, but also to serum periosteal protein, IL-6, and S100B protein levels. In clinical practice, these risk factors should be identified as early as possible and targeted preventive measures should be taken.
杨莉莎. 高分级动脉瘤性蛛网膜下腔出血患者早期脑损伤的影响因素分析[J]. 医学临床研究, 2023, 40(12): 1919-1921.
YANG Lisha. Analysis of Influencing Factors of Early Brain Injury in High-grade Aneurysmal Subarachnoid Hemorrhage. JOURNAL OF CLINICAL RESEARCH, 2023, 40(12): 1919-1921.
[1] REHMAN S, CHANDRA RV, ZHOU K, et al. Sex differences in aneurysmal subarachnoid haemorrhage (aSAH): aneurysm characteristics, neurological complications, and outcome[J].Acta Neurochir (Wien),2020, 162(9):2271-2282. [2] 张国锋, 冷巧云, 刘慧, 等. 高级别动脉瘤性蛛网膜下腔出血预后影响因素分析[J].中华神经医学杂志, 2021, 20(4):378-383. [3] PROUST F, BRACARD S, THINES L, et al. Functional outcome 1 year after aneurysmal subarachnoid hemorrhage due to ruptured intracranial aneurysm in elderly patients[J].Neurochirurgie,2020, 66(1):1-8. [4] 廖艺斐, 张慧, 邹良玉. 神经炎症在动脉瘤性蛛网膜下腔出血后早期脑损伤中的作用[J].中国卒中杂志, 2021, 16(1):92-96. [5] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国蛛网膜下腔出血诊治指南2015[J].中华神经科杂志, 2016, 49(3):182-191. [6] WAGNER S, GÜTHE T, BHOGAL P, et al. Aneurysmal subarachnoid hemorrhage as a trigger for Takotsubo syndrome: a comprehensive review[J].Rev Cardiovasc Med,2021, 22(4):1241-1251. [7] 张杰, 彭俊. 动脉瘤性蛛网膜下腔出血患者早期脑损伤生物标志物的研究进展[J].中国脑血管病杂志, 2021, 18(12):876-880. [8] XU L B, HUANG H D, ZHAO M, et al. Intranasal insulin treatment attenuates metabolic distress and early brain injury after subarachnoid hemorrhage in mice[J].Neurocrit Care,2021, 34(1):154-166. [9] 杨定博, 俞文华, 杜权, 等. 动脉瘤性蛛网膜下腔出血患者血清骨膜蛋白水平及临床价值[J].心脑血管病防治, 2020, 20(3):235-238. [10] SAVARRAJ J, PARSHA K, HERGENROEDER G, et al. Early brain injury associated with systemic inflammation after subarachnoid hemorrhage[J].Neurocrit Care,2018, 28(2):203-211. [11] 张魁, 闫换, 綦梅伶, 等. 血清白细胞介素-6预测动脉瘤性蛛网膜下腔出血后迟发性脑缺血[J].国际脑血管病杂志, 2020, 28(7):505-509. [12] KEDZIORA J, BURZYNSKA M, GOZDZIK W, et al. Biomarkers of neurological outcome after aneurysmal subarachnoid hemorrhage as early predictors at discharge from an intensive care unit[J].Neurocrit Care,2021, 34(3):856-866. [13] SANGEETHA RP, RAMESH VJ, KAMATH S, et al. Effect of remote ischemic preconditioning on cerebral vasospasm and biomarkers of cerebral ischemia in aneurysmal subarachnoid hemorrhage (ERVAS): A protocol for a randomized, controlled pilot trial[J].Brain Circ,2019, 5(1):12-18.
2023, Vol. 40 
