The value of plasma Lp-PLA2 combined with GOS score in evaluating the prognosis of aneurysm subarachnoid hemorrhage interventional therapy

doi:10.19854/j.cnki.1008-2425.2023.02.0008

Abstract

Abstract: Objective To investigate the prognostic value of plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) combined with Glasgow Outcome Scale (GOS) score in assessing the prognostic value of interventional therapy for aneurysmal subarachnoid hemorrhage (aSAH).Methods From June 2018 to December 2020,86 patients with aSAH who received endovascular interventional aneurysm embolization were selected.GOS score was performed at discharge;modified Rankin Scale (mRS) score was performed at 6 months after discharge,with 0 2 being a good prognosis (n=63);3 6 being a poor prognosis (n=23).Plasma Lp-PLA2 levels were detected by enzyme-linked immunosorbent assay kit.Logistic multivariate analysis was used to analyze the influencing factors of poor prognosis in patients with aSAH;receiver operating characteristic curve (ROC) was used to analyze the value of Lp-PLA2 and GOS score to evaluate the prognosis.Results Logistic multivariate analysis showed that age (OR=1.834),preoperative Hunt-Hess grade (OR=4.123),aneurysm diameter (OR=5.002),number of aneurysms (OR=2.567),Lp-PLA2 expression level (OR=4.671) and GOS score at discharge (OR=2.678) were independent influencing factors of poor prognosis of aSAH patients (P＜0.05).The AUCs of Lp-PLA2 and GOS scores for predicting poor prognosis were 0.793 and 0.725,respectively,and the combined AUC was 0.891.The combined prediction had a sensitivity of 87.23% and a specificity of 76.12%.Conclusion Plasma Lp-PLA2 combined with GOS score has important value in evaluating the prognosis of aSAH patients.Conclusion Plasma Lp-PLA2 combined with GOS score has important value in evaluating the prognosis of aSAH patients.

Key words: Lipoprotein-associated phospholipase A2, Glasgow outcome scale, Aneurysmal subarachnoid hemorrhage, Interventional therapy, Prognosis

摘要： 目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)结合格拉斯哥预后量表(GOS)评分评估动脉瘤蛛网膜下腔出血(aSAH)介入治疗的预后价值。方法 2018年6月至2020年12月选取接受血管内介入动脉瘤栓塞术治疗的86例aSAH病人。出院时进行GOS评分;出院后6个月时对病人进行改良Rankin量表(mRS)评分,0 2分为预后良好(n=63);3 6分为预后不良(n=23)。用酶联免疫吸附实验试剂盒检测血浆Lp-PLA2水平。用Logistic多因素分析aSAH病人不良预后的影响因素;受试者工作特征曲线(ROC)分析Lp-PLA2、GOS评分评估预后的价值。结果 Logistic多因素分析结果显示年龄(OR=1.834)、术前Hunt-Hess 分级(OR=4.123)、动脉瘤直径(OR=5.002)、动脉瘤个数(OR=2.567)、Lp-PLA2表达水平(OR=4.671)、出院时GOS评分(OR=2.678)是aSAH病人不良预后的独立影响因素(P＜0.05)。Lp-PLA2、GOS评分预测病人不良预后的AUC分别为0.793和0.725,联合预测的AUC为0.891。联合预测的灵敏度为87.23%,特异度为76.12%。结论血浆Lp-PLA2结合GOS评分对评估aSAH病人的预后有重要价值。

CLC Number:

R743.34

姜海洋, 陈虎, 郭星, 张登文. 血浆Lp-PLA2结合GOS评分评估动脉瘤蛛网膜下腔出血介入治疗预后的价值[J]. 立体定向和功能性神经外科杂志, 2023, 36(2): 100-104.

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