血浆和肽素与动脉瘤性蛛网膜下腔出血血管痉挛相关性的临床分析

发布时间：2019-06-07 19:53

【摘要】：目的：预测血浆copeptin水平与aSAH血管痉挛的相关性，，提前预警，减少aSAH血管痉挛并发症的发生率，降低病残率及病死率。方法：选取吉林大学第一医院神经血管病外科2013年7月1日-2013年12月31日期间50例经我院神经血管病外科收治的aSAH患者。所有破裂出血颅内动脉瘤均经头部CTA或者DSA证实。所有SAH病例于发病第3、5、7、14天留取2mlEDTA抗凝血行copeptin检测及TCD检查。结果：在对入组的50例患者分别于发病第3、5、7、14天血浆copeptin值检测结果中，与对照组比较，均有不同程度升高，最低值8.2pmol/L,最高值38.7pmol/L，平均值17.8pmol/L.病程中行TCD检测示：发病3天时行TCD检测的50例血流速度正常者18例,轻度脑血管痉挛者25例,中度痉挛者5例,重度痉挛者2例;发病5天时行TCD检测的50例血流速度正常者16例,轻度脑血管痉挛者24例,中度痉挛者7例,重度痉挛者3例;发病7天时行TCD检测的50例血流速度正常者12例,轻度脑血管痉挛者28例,中度痉挛者8例,重度痉挛者2例;发病14天时行TCD检测的50例血流速度正常者25例,轻度脑血管痉挛者22例,中度痉挛者2例,重度痉挛者1例。结论： 1、血浆copeptin水平与aSAH血管痉挛有一定相关性.在发病后3-14天血浆copeptin水平升高，在发病7天左右达到最高值。 2、发生aSAH血管痉挛后，3-14天内血浆copeptin平均值17.8pmol/L。 3、TCD检查对脑血管痉挛的评估有一定局限性，不能取代DSA。
[Abstract]:Objective: to predict the correlation between plasma copeptin level and aSAH vasospasm, to predict the early warning, to reduce the incidence of complications of aSAH vasospasm, and to reduce the disability rate and mortality. Methods: from July 1, 2013 to December 31, 2013, 50 patients with aSAH were treated in the Department of Neurovascular Diseases, the first Hospital of Jilin University. All ruptured intracranial aneurysm were confirmed by head CTA or DSA. 2mlEDTA anticoagulation was taken on the 3rd, 5th, 7th and 14th day after onset of SAH for copeptin and TCD. Results: the plasma copeptin values of 50 patients in the control group were significantly higher than those in the control group on the 3rd, 5th and 14th day after onset, the lowest value was 8.2 pmol / L, the highest value was 38.7 pmol 路L, the average was 17.8 pmol 路L ~ (- 1), the lowest value was 8.2 pmol / L, the highest value was 38.7 pmol 路L ~ (- 1), and the highest value was 38.7 pmol 路L ~ (- 1). During the course of disease, TCD showed that there were 18 cases of normal blood flow velocity, 25 cases of mild cerebral vasospasm, 5 cases of moderate spasm and 2 cases of severe spasm detected by TCD on the 3rd day of onset. On the 5th day of onset, TCD was performed in 16 cases of normal blood flow velocity, 24 cases of mild cerebral vasospasm, 7 cases of moderate spasm and 3 cases of severe spasm. On the 7th day of onset, TCD was performed in 12 cases of normal blood flow velocity, 28 cases of mild cerebral vasospasm, 8 cases of moderate spasm and 2 cases of severe spasm. On the 14th day of onset, TCD was performed in 25 cases with normal blood flow velocity, 22 cases with mild cerebral vasospasm, 2 cases with moderate spasm and 1 case with severe spasm. Conclusion: 1. There is a certain correlation between plasma copeptin level and aSAH vasospasm. The plasma copeptin level increased on the 14th day after onset and reached the highest level on the 7th day after onset. 2. After aSAH vasospasm, the mean value of plasma copeptin was 17.8 pmol / L 3 within 3 卤14 days. Copeptin examination has certain limitations in the evaluation of cerebral vasospasm and can not replace DSA..
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.41

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