BACKGROUND Delayed cerebral ischemia (DCI) is a severe complication after aneurysmal subarachnoid hemorrhage (aSAH). Tissue kallikrein (TK), a subgroup of serine proteinases, is an important component of the kallikrein-kinin system. Exogenous TK attenuated cerebral vasospasm in a rabbit model of subarachnoid hemorrhage. We intended to discern association of serum TK levels with aSAH-related DCI. METHODS Serum TK levels were detected in a total of 92 aSAH patients and 92 healthy controls. A multivariate logistic regression model was configured to investigate relationship between TK levels and occurrence of DCI. RESULTS TK levels were substantially lower in aSAH patients than in controls. TK levels were strongly correlated with World Federation of Neurological Surgeons (WFNS) score and modified Fisher score. Serum TK, WFNS score and modified Fisher score retained as the three independent predictors for DCI. Under receiver operating characteristic curve, predictive capability of TK levels was in the range of WFNS score and modified Fisher score, as well as TK levels could remarkably improve predictive abilities of WFNS score and modified Fisher score. CONCLUSIONS Serum TK emerges as a potential biomarker for assessment of hemorrhagic severity and prediction of DCI following aSAH.

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组织激肽释放酶：一种潜在的血清生物标志物，可预测动脉瘤性蛛网膜下腔出血的延迟性脑缺血。

背景技术延迟性脑缺血（DCI）是动脉瘤性蛛网膜下腔出血（aSAH）后的严重并发症。组织激肽释放酶（TK）是丝氨酸蛋白酶的一个亚组，是激肽释放酶激肽系统的重要组成部分。外源性TK减弱了蛛网膜下腔出血兔模型的脑血管痉挛。我们打算辨别血清TK水平与aSAH相关DCI的关联。方法在92例aSAH患者和92例健康对照者中检测血清TK水平。配置了多元逻辑回归模型以研究传统知识水平与DCI发生之间的关系。结果aSAH患者的TK水平明显低于对照组。TK水平与世界神经外科医师联合会（WFNS）评分和改良的Fisher评分密切相关。血清TK WFNS评分和改良的Fisher评分保留为DCI的三个独立预测因子。在接收者工作特征曲线下，TK水平的预测能力在WFNS评分和改良的Fisher评分范围内，而TK水平可以显着提高WFNS评分和修正的Fisher评分的预测能力。结论血清TK可以作为评估aSAH后出血严重程度和预测DCI的潜在生物标志物。