Prediction value of cerebrospinal fluid analysis for subacute hydrocephalus after interventional operation of aneurysmal subarachnoid hemorrhage
LI Yunfei 1，2, CHENG Qiong 1，2, WANG Yinzhou 1，2, LIU Junpeng 2, ZHENG Zheng 2, WEI Wen 3
1. Provincial Clinical College, Fujian Medical University, Fuzhou Fujian 350001; 2. Department of Neurology, Fujian Provincial Hospital, Fuzhou Fujian 350001; 3. Department of Rehabilitation Medicine, Ganzhou Municipal Hospital, Ganzhou Jiangxi 341000, China
Abstract：Objective： To explore the predictors of hydrocephalus within 30 days in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods: A total of 147 patients with aSAH who were hospitalized in the Department of Neurology of Fujian Provincial Hospital from January 2017 to August 2021 and underwent emergency endovascular interventional embolization were selected and divided into subacute hydrocephalus group (n=50) and non-hydrocephalus group (n=97), according to the results of CT examination within 30 days of onset. Cerebrospinal fluid replacement by lumbar puncture was performed in all patients within 3 days after surgery. Quantitative analysis indexes such as cerebrospinal fluid pressure, white blood cell count, red blood cell count, protein content and IL-6 were recorded for the first time. Clinical and imaging indexes of the two groups were collected and compared, and univariate and multivariate Logistic regression were used to analyze the risk factors for subacute hydrocephalus. The predictive threshold of hydrocephalus was determined by receiver operating characteristic (ROC) curve analysis. Results: There were statistically significant differences in HuntHess grading≥3 points, modified Fisher grading≥grade Ⅲ, ventricle hemorrhage, preoperative hydrocephalus, increased red blood cell count and IL-6 level in cerebrospinal fluid between 2 groups (P<0.01 or P<0.05), while no statistically significant differences in other indicators (all P>0.05). Multivariate Logistic regression analysis showed that ventricle hemorrhage, preoperative hydrocephalus, increased red blood cell count and IL-6 level in cerebrospinal fluid were independent risk factors for hydrocephalus within 30 days after surgery in patients with aSAH (P<0.05). ROC curve results showed that the areas under the curve of red blood cell count and IL-6 level in cerebrospinal fluid in predicting hydrocephalus in aSAH patients within 30 days after surgery were 0.627 and 0.966, respectively; and the diagnostic thresholds were 78 950×106/L and 62.25 pg/mL, respectively. Conclusions: Quantitative analysis of IL-6 in cerebrospinal fluid within 3 days after aneurysm embolization could be used to predict subacute hydrocephalus in patients with aSAH.
［Key words］aneurysm subarachnoid hemorrhage; hydrocephalus; cerebrospinal fluid; IL-6; red blood cell count; white blood cell count
基金资助:福建省科技厅引导性项目(2016Y0016，2017Y19)
通讯作者:
程琼，主任医师，E-mail： chengqiong13@126.com
作者简介: 李云飞(1983—)，女，硕士，副主任医师，主要从事脑血管病的研究
引用本文:
李云飞， 程琼， 汪银洲， 等. 脑脊液分析对动脉瘤性蛛网膜下腔出血介入术后亚急性脑积水的预测价值[J]. 江苏大学学报:医学版, 2023, 33(03): 258-264.
LI Yunfei, CHENG Qiong, WANG Yinzhou, et al. Prediction value of cerebrospinal fluid analysis for subacute hydrocephalus after interventional operation of aneurysmal subarachnoid hemorrhage. Journal of Jiangsu University(Medicine Edition), 2023, 33(03): 258-264.
