动脉瘤性蛛网膜下隙出血病人血清犬尿氨酸水平与脑水肿相关性  

ASSOCIATION BETWEEN SERUM KYNURENINE LEVEL AND BRAIN EDEMA IN PATIENTS WITH ANEURYSMAL SU-BARACHNOID HEMORRHAGE

作　　者：谢永帆 周勇 王永意 徐志明[1] 李彤 王伟民 XIE Yongfan;ZHOU Yong;WANG Yongyi;XU Zhiming;LI Tong;WANG Weimin(Department of Neurosurgery,Qingdao Municipal Hospital,The Affiliated Hospital of Qingdao University,Qingdao 266011,China)

机构地区：[1]青岛大学附属青岛市市立医院神经外科,山东青岛266011

出　　处：《青岛大学学报（医学版）》2022年第3期424-427,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省脑功能重构省级重点实验室项目(2020-NGN002)。

摘　　要：目的探讨动脉瘤性蛛网膜下隙出血(aSAH)病人血清犬尿氨酸途径(KP)代谢物水平变化及其与脑水肿的相关性。方法以aSAH病人32例为研究组,健康志愿者28例为对照组。aSAH病人分别于发病24 h内(1 d)及入院2、3、4 d和7 d采血,采用高效液相色谱(HPLC)法测定色氨酸(TRP)、犬尿氨酸(KYN)、犬尿喹啉酸(KYNA)浓度,气相色谱/质谱联用(GC/MS)法测定喹啉酸(QA)浓度;aSAH病人发病24 h内行颅脑CT检查,使用SAH早期脑水肿评分(SEBES)评估脑水肿程度,并与对照组比较。结果与对照组比较,研究组血清TRP(2、3、4 d)降低,而KYN(4、7 d)、KYNA(3、4、7 d)、QA(2、3、4、7 d)升高,差异均有显著性(F=3.040~8.690,P<0.05)。aSAH后1 d血清QA与SEBES呈正相关(r=0.39,P<0.05),TRP、KYN、KYNA与SEBES均无显著相关性(r=-0.11~0.28,P>0.05)。结论aSAH急性期病人体内KP代谢物发生显著性变化,血清QA与脑水肿程度存在相关性,是早期预测脑水肿发生发展的潜在生物标志物。Objective To investigate the change in serum metabolites of the kynurenine pathway(KP)in patients with aneurysmal subarachnoid hemorrhage(aSAH)and its association with brain edema.Methods A total of 32 patients with aSAH were enrolled as study group,and 28 healthy volunteers were enrolled as control group.For the patients with aSAH,blood samples were collected within 24 h(1 d)after aSAH onset and on days 2,3,4,and 7 after admission;high-performance liquid chromatography was used to measure the concentration of tryptophan(TRP),kynurenine(KYN),and kynurenic acid(KYNA),and gas chromatography-mass spectrometry was used to measure the concentration of quinolinic acid(QA);brain CT was performed within 24 h after aSAH onset,and Subarachnoid Hemorrhage Early Brain Edema Score(SEBES)was used to evaluate the severity of brain edema and compare it with the control group.Results Compared with the control group,the study group had a significant reduction in serum TRP(days 2,3,and 4)and significant increases in KYN(days 4 and 7),KYNA(days 3,4 and 7),and QA(days 2,3,4,and 7)(F=3.040-8.690,P<0.05).Serum QA level on day 1 after aSAH onset was positively correlated with SEBES(r=0.39,P<0.05),and TRP,KYN,and KYNA levels had no significant correlation with SEBES(r=-0.11-0.28,P>0.05).Conclusion There is a significant change in metabolites of the KP pathway in the acute stage of aSAH.Serum QA level is correlated with the severity of brain edema and might be a potential biomarker for early prediction of the development and progression of brain edema.

关 键 词：蛛网膜下隙出血 犬尿氨酸 喹啉酸 脑水肿 

分 类 号：R743.35[医药卫生—神经病学与精神病学]