血神经纤维光链作为一个生物标志物,用于贫困的结果后,动脉瘤下大脑关节出血
Homeyra Labib1, Maud A Tjerkstra1, Charlotte E Teunissen2
1Department of Neurosurgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Neurovascular Disorders, Amsterdam Neurosciences, Amsterdam, the Netherlands.
World neurosurgery
|June 12, 2024
概括
神经纤维光链 (NfL) 显示了可接受的预测,在动脉瘤下关节出血 (aSAH) 后的糟糕结果. 然而,当与现有尺度相结合时,NfL并没有改善预测,但在特定的患者子组中可能是有价值的.
科学领域:
- 神经学 神经学
- 生物标志物 生物标志物
- 神经临界护理是指神经临界护理.
背景情况:
- 动脉瘤下关节出血 (aSAH) 对神经学结果差的显著风险.
- 神经纤维光链 (NfL) 是神经轴突损伤的生物标志物.
- 准确预测结果对于管理aSAH患者至关重要.
研究的目的:
- 评估NfL对aSAH患者临床结果的预测价值.
- 为了确定NfL是否会改善预测,当添加到已建立的分级尺度 (WFNS,修改过的费舍尔).
- 探索NfL在预测不同出血严重程度小组的结果中的实用性.
主要方法:
- 在一个单一的三级中心对aSAH患者进行前性队列研究.
- 在中风24小时内采集的血液样本用于NfL测量.
- 6个月后评估结果;用于确定NfL,WFNS,修改后的Fisher,年龄和性别的曲线下面积 (AUC) 的接收器操作曲线 (ROC) 分析.
主要成果:
- 对于不良结果 (AUC 0.70),NfL显示了可接受的预测性表现.
- 将NfL与世界神经外科协会联合会 (WFNS) 规模相结合,显示了更高的模型合适性 (R20.51) 和AUC (0.86),但不显著地比单独的WFNS更好.
- 在等级差的患者和在等级差子组中的未生存者中观察到高NfL水平.
结论:
- 血NfL对aSAH结果具有可接受的预测性能,但与现有尺度相结合时不会显著提高预测.
- 在特定的患者亚组中,NfL可能对预测结果具有潜在的价值,特别是那些根据出血严重程度分层的患者.
- 对NfL在针对性aSAH患者管理中的作用进行进一步的研究是有必要的.
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