中国卒中杂志2019，Vol.14Issue(5)：414-421,8.DOI:10.3969/j.issn.1673-5765.2019.05.003
急性期胰岛素样生长因子-1对动脉瘤性蛛网膜下腔出血院内并发症及短期预后的预测作用
Predictive Value of Insulin like Growth Factor-1 for Inhospital Complications and Short-term Outcome after Aneurysmal Subarachnoid Hemorrhage
摘要
Abstract
Objective To investigate the predictive value of insulin like growth factor-1 (IGF-1) for inhospital complications and short-term clinical outcomes after aneurysmal subarachnoid hemorrhage (aSAH). Methods Patients who were diagnosed as aSAH and within 72 h after symptom onset were selected. Upon admission and before aneurysm occlusion, plasma IGF-1 levels were measured. Patients with aneurysmal subarachnoid hemorrhage characteristics, perioperative complications and outcomes at discharge were analyzed. Logistic regression analyse was performed to identify independent factors associated with the poor clinical outcomes (mRS>2) and complications in hospital. Results 118 consecutive aSAH patients and 122 health controls were evaluated. The IGF-1 levels of aSAH patients were lower than that of health controls [69.00 (50.98, 93.85) ng/mL vs 81.05 (69.40, 102.78) ng/mL, P<0.0001]. A total of 37 patients with aSAH (31.4%) had poor outcomes at discharge. More lower IGF-1 level ( OR 0.971, 95% CI 0.946-0.996, P=0.0262), higher Hunt-Hess scales (III-V, OR 4.995, 95% CI 1.331-18.747, P=0.0007), delayed cerebral ischemia (OR 46.100, 95% CI 11.152-190.566, P<0.0001) and hydrocephalus ( OR 7.768, 95% CI 1.088-55.463, P=0.0284) in hospital were associated with poor clinical outcomes at discharge. The AUC of the IGF-1 level was similar to that of the Hunt-Hess scales and delayed cerebral ischemia for the prediction of poor outcome at discharge (P>0.05). A total of 71 aSAH patients (60.2%) had at least one complication. Only the IGF-1 level on admission ( OR 0.984, 95% CI 0.973-0.996, P=0.0082) can predict complications in hospital. Conclusions Lower IGF-1 levels at acute phase is the predictive factor for inhospital complications and short-term poor outcome in patients with acute aSAH.关键词
蛛网膜下腔出血/动脉瘤/神经内分泌/预后/并发症Key words
Subarachnoid hemorrhage/Aneurysm/Neuroendocrine/Outcome/Complication引用本文复制引用
BIAN Li-Heng,ZHAO Xing-Quan..急性期胰岛素样生长因子-1对动脉瘤性蛛网膜下腔出血院内并发症及短期预后的预测作用[J].中国卒中杂志,2019,14(5):414-421,8.基金项目
北京市医院管理局"登峰"人才培养计划(DFL20150501) （DFL20150501）
