D-二聚体对颅内动脉瘤预后的预测价值  

The predictive role of D-dimer in the prognosis of intracranial aneurysms

作　　者：高丹丹 侯斌 高阳 李创忠 Gao Dandan;Hou Bin;Gao Yang;Li Chuangzhong(Department of Neurosurgery,General Hospital of the Northern Theater Command,Shenyang,Liaoning 110016,China)

机构地区：[1]北部战区总医院神经外科,辽宁沈阳110016

出　　处：《中国微侵袭神经外科杂志》2025年第2期74-77,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的分析D-二聚体对动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)预后的预测价值。方法回顾性分析150例颅内动脉瘤患者临床资料,其中Hunt-Hess分级:0级(未破裂)50例,Ⅰ~Ⅱ级为轻症aSAH 50例,Ⅲ~Ⅴ级为重症aSAH 50例。所有患者均采用介入栓塞治疗。术后随访采用改良Rankin量表(modified Rankin scale,mRS)评估预后,mRS 0~2分为预后良好组,3~5分为预后不良组。比较预后良好组和预后不良组患者的血清D-二聚体,计算D-二聚体对预后的预测效能。结果预后良好组127例,预后不良组23例。两组间D-二聚体与住院天数差异均具有统计学意义(均P<0.05)。D-二聚体对不同预后的颅内动脉瘤患者的截断值为1.99,曲线下面积为0.94(95%CI为0.90~0.98,P<0.0001),敏感度为77.8%,特异度为70.3%。结论D-二聚体对颅内动脉瘤患者预后不良有一定预测价值。Objective To analyze serum indicators for predicting the prognosis of aneurysmal subarachnoid hemorrhage(aSAH).Methods Clinical data of 150 patients with intracranial aneurysms were analyzed retrospectively.These patients were categorized based on Hunt-Hess grading:50 cases of grade 0(unruptured),50 cases of mild aSAH(gradesⅠ-Ⅱ),and 50 cases of severe aSAH(gradesⅢ-V).All the patients underwent interventional embolization.Postoperative follow-up was conducted using the modified Rankin scale(mRS)to assess prognosis,and the patients with mRS of 0-2 were divided into the good prognosis group and 3-5 divided into the poor prognosis group.Serum D-dimer levels were compared between the two groups,and the sensitivity and specificity of D-dimer were analyzed.Results There were 127 cases in the good prognosis group and 23 in the poor prognosis group.There was a statistically significant difference in D-dimer and length of hospital stay between the two groups(both P<0.05).The cut-off value of D-dimer for patients with intracranial aneurysm with different prognosis was 1.99,AUC was 0.94,(95%CI:0.90-0.98,P<0.0001),the sensitivity was 77.8%and specificity 70.3%.Conclusions There are many factors affecting the prognosis of intracranial aneurysm,and clinical intervention should be taken in advance according to the specific characteristics of patients.D-dimer has a certain predictive value for the poor prognosis of patients with intracranial aneurysm.

关 键 词：颅内动脉瘤 蛛网膜下腔出血 D-二聚体 影响因素 预测价值 

分 类 号：R651.12[医药卫生—外科学]