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Serum myelin basic protein as a marker of brain injury in aneurysmal subarachnoid haemorrhage.
Acta Neurochirurgica ( IF 1.9 ) Pub Date : 2020-01-08 , DOI: 10.1007/s00701-019-04185-9
Norbert Wąsik 1 , Bartosz Sokół 1 , Marcin Hołysz 2 , Witold Mańko 3 , Robert Juszkat 1, 4 , Piotr Paweł Jagodziński 2 , Roman Jankowski 1
Affiliation  

BACKGROUND Myelin basic protein (MBP) is the second most abundant protein in central nervous system myelin. Since the 1980s, it has been regarded as a marker of brain tissue injury in both trauma and disease. There have been no recent reports regarding MBP in aneurysmal subarachnoid haemorrhage (SAH). METHODS One hundred four SAH patients with ruptured aneurysms underwent endovascular treatment within 24 h of rupture, and 156 blood samples were collected: 104 on days 0-3, 32 on days 4-6 and 20 on days 9-12 post-SAH. MBP levels were assayed using ELISA and compared with the clinical status on admission, laboratory results, imaging findings and treatment outcome at 3 months. RESULTS MBP levels on days 0-3 post-SAH were significantly higher among poor outcome patients (p < 0.001), non-survivors (p = 0.005), patients who underwent intracranial intervention (p < 0.001) and patients with intracerebral haemorrhage (ICH; p < 0.001). On days 4-6 post-SAH, significantly higher levels were found following intracranial intervention (p = 0.009) and ICH (p = 0.039). There was clinically relevant correlation between MBP levels on days 0-3 post-SAH and 3-month Glasgow Outcome Scale (cc = - 0.42) and also ICH volume (cc = 0.48). All patients who made a full recovery had MBP levels below detection limit on days 0-3 post-SAH. Following endovascular aneurysm occlusion, there was no increase in MBP in 86 of the 104 patients investigated (83%). CONCLUSIONS The concentration of MBP in peripheral blood after intracranial aneurysm rupture reflects the severity of the brain tissue injury (due to surgery or ICH) and correlates with the treatment outcome. Endovascular aneurysm occlusion was not followed by a rise in MBP in most cases, suggesting the safety of this technique.

中文翻译:

血清髓鞘碱性蛋白是动脉瘤蛛网膜下腔出血中脑损伤的标志物。

背景技术髓磷脂碱性蛋白(MBP)是中枢神经系统髓磷脂中第二丰富的蛋白。自1980年代以来,它一直被认为是创伤和疾病中脑组织损伤的标志。最近没有关于MBP在动脉瘤性蛛网膜下腔出血(SAH)中的报道。方法144例SAH动脉瘤破裂的患者在破裂后24小时内接受了血管内治疗,收集了156份血液样本:SAH后0-3天104例,4-6天32例,9-12天20例。使用ELISA测定MBP水平,并与入院时的临床状况,实验室结果,影像学发现和3个月的治疗结果进行比较。结果SAH后0-3天的MBP水平在不良结局患者(p <0.001),非幸存者(p = 0.005),接受颅内介入治疗的患者(p <0.001)和脑出血患者(ICH; p <0.001)。在SAH后第4-6天,颅内干预(p = 0.009)和ICH(p = 0.039)后发现明显更高的水平。SAH后0-3天和3个月的格拉斯哥成果量表(cc =-0.42)与ICH量(cc = 0.48)之间的MBP水平存在临床相关性。在SAH后0至3天,所有完全康复的患者MBP水平均低于检出限。血管内动脉瘤闭塞后,研究的104例患者中有86例(83%)的MBP没有增加。结论颅内动脉瘤破裂后外周血中MBP的浓度反映了脑组织损伤的严重程度(由于手术或ICH),并与治疗结果相关。
更新日期:2020-01-21
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