介入治疗和开颅夹闭术后脑脊液中S100B的表达差异及其与脑血管痉挛之间的关系  

Difference of CSF S100B in patients treated by endovascular coiling or surgical clipping after aneurysmal subarachnoid hemorrhage and its correlation to cerebral vasospasm

作　　者：李瑞岩[1] 李庆斌[1] 袁清华[1] 陈明辉[1] 冯岩[1] 李永利[1] 

机构地区：[1]哈尔滨医科大学附属第二医院神经外科,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2017年第5期430-433,共4页Journal of Harbin Medical University

基　　金：黑龙江省教育厅科学技术研究项目(12531395)

摘　　要：目的动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,a SAH)患者行开颅夹闭术或介入治疗后采用电化学发光免疫分析法(electrochemiluminescence immunoassay,ECLIA)检测脑脊液中S100B表达差异,并探索S100B是否可作为一种潜在的脑血管痉挛(cerebral vasospasm,CVS)预测因子。方法 51例动脉瘤性蛛网膜下腔出血的患者经腰椎穿刺术各取5份脑脊液样本,使用ECLIA进行检测。结果接受开颅夹闭术的患者每日S100B的浓度在某种程度具有高于接受介入治疗的患者的趋势,但其差异不具有统计学意义;通过使用单变量分析提示不同时间点的脑脊液S100B浓度及平均脑脊液S100B浓度能够预测到脑血管痉挛的发生风险(P<0.05),通过使用ROC曲线及多元变量分析提示不同时间点的脑脊液S100B浓度及平均脑脊液S100B浓度不能预测脑血管痉挛的发生。结论脑脊液中S100B能够作为脑血管痉挛的发生风险的预测因子,但不能独立地预测脑血管痉挛的发生。Objective To examine the differences of S100B in cerebrospinal fluid （CSF） be- tween patients treated byendovascular coiling andsurgieal clipping after aneurysmalsubarachnoid hemorrhage （aSAH）. Andto explore whether S100B could be used as a potential predictor of cerebral vasospasm （CVS） after aSAH. Methods Five CSFsamples from each of 51 patients with aSAH were obtained via lumbar puncture and were detected using electrochemilumines- cence immunoassay （ECLIA）. Results There was a tendency that the amount of S100B of patients treated with surgical clipping was somehow higher than that treated with endovascular coiling at each day, but it was not statistically significant; the CSF SIOOB level of different time points and the mean CSF S100B level can predict the risk of CVS using univariate analysis （P 〈 0. 05 ） , but the CSF S100B level of different time points as well as the mean CSF S100B level could not predict CVS by multivariate analysis. Conclusion CSF S100B can be a predictor of the risk of CVS, but cannot predict CVS independently.

关 键 词：动脉瘤性蛛网膜下腔出血 S100B 开颅夹闭术 介入治疗 脑血管痉挛 

分 类 号：R743.3[医药卫生—神经病学与精神病学]