| 摘要: |
| 目的：揭示动脉瘤性蛛网膜下腔出血(aSAH)后血清铁死亡相关基因酰基辅酶A合成酶长链家族成员4(ACSL4)浓度的变化及其与疾病严重程度和不良预后的关系。方法：纳入2023年1月至2025年2月杭州市第一人民医院收治的122例aSAH患者和112例正常人群(对照组),收集临床资料,采用入院时世界神经外科医师联盟量表(WFNS)评分和改良Fisher评分评价aSAH疾病严重度,并检测入院时血清ACSL4浓度,采用格拉斯哥预后(GOS)评分评估aSAH后3个月的神经功能状态,并定义GOS评分1-3为预后不良,采用多因素分析血清ACSL4浓度与病情严重程度及不良预后的关系。结果： aSAH患者血清ACSL4浓度显著高于健康对照组(P<0.01),且与WFNS评分和改良Fisher评分呈独立相关性(P均<0.01)。WFNS评分、改良Fisher评分和血清ACSL4浓度可独立预测aSAH后3个月预后不良(P均<0.05)。在受试者工作特征曲线下,血清ACSL4浓度对预后不良的预测价值与WFNS评分和改良Fisher评分相似(P均>0.05)。与WFNS评分和改良Fisher评分联合模型相比,血清ACSL4浓度和前两者联合模型具有更高的预测价值和模型提高率 (P均<0.05)。结论：aSAH后升高的血清ACSL4浓度与病情严重程度及3个月不良预后密切相关,且血清ACSL浓度具有较高的预后预测价值,提示血清ACSL4可能是aSAH潜在的预后标志物。 |
| 关键词: 动脉瘤性蛛网膜下腔出血,铁死亡相关基因酰基辅酶A合成酶长链家族成员4,严重度,预后,生物标志物 |
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| Analysis of predictive value of serum ACSL4 concentrations on poor prognosis following aneurysmal subarachnoid hemorrhage |
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Yidong Jin1, Tiancheng Lu1, Boren Zheng1, Xiaoqiao Dong2,3,4, Xue Zhao5,6,7,8,6,7,4
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1.The Fourth School of Medicine, Zhejiang Chinese Medical University;2.The Hangzhou First People'3.'4.s Hospital;5.The Hangzhou First People&6.amp;7.#39;8.&
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| Abstract: |
| Objective: To investigate change of serum Acyl-CoA synthetase long chain family member 4 (ACSL4) levels after aneurysmal subarachnoid hemorrhage (aSAH) and its relationship with clinical severity and poor prognosis of aSAH. Methods: A total of 122 patients with aSAH who were hospitalized to the Hangzhou First People"s Hospital from January 2023 to February 2025, and 112 healthy individuals (controls) were enrolled in this study. Clinical data were obtained, clinical severity was evaluated by applying the World Federation of Neurosurgeons (WFNS) scale and modified Fisher (mFisher), admission ACSL4 concentrations were measured, Glasgow outcome scale (GOS) was adopted to assess neurological functional status 3 months following aSAH, GOS of 1-3 was designated as poor prognosis and multivariate analysis was performed to explore the relationship between serum ACSL4 levels and disease severity as well as poor prognosis. Results: Serum ACSL4 concentrations in aSAH patients were significantly higher than those in controls (P < 0.01), and were independently correlated with WFNS scores and mFisher scores (both P < 0.05). WFNS scores, mFisher scores and serum ACSL4 levels independently predicted 3-month poor prognosis after aSAH (all P < 0.05) Under the receiver operating characteristic curve, serum ACSL4 levels had analogous prognostic predictive value, as compared to WFNS scores and mFisher scores (both P>0.05). As opposed to combined model of WFNS scores and mFisher scores, merged model of serum ACSL4 concentrations and the former two indexes possessed significantly higher prognostic predictive ability and model improvement rate (all P<0.05). Conclusions: Increased serum ACSL4 concentrations following aSAH are intimately correlated with diseases severity and 3-month poor prognosis, as well as serum ACSL4 concentrations hold relatively high prognostic predictive value. Overall, serum ACSL4 may be a potential prognostic biomarker of aSAH. |
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