PDF(Pubmed)
Abstract：
Absent in melanoma 2 (AIM2) is implicated in neuroinflammation. Here, we explored the prognostic significance of serum AIM2 in human aneurysmal subarachnoid hemorrhage (aSAH). We conducted a consecutive enrollment of 127 patients, 56 of whom agreed with blood-drawings not only at admission but also at days 1, 2, 3, 5, 7 and 10 days after aSAH. Serum AIM2 levels of patients and 56 healthy controls were measured. Disease severity was assessed using the modified Fisher scale (mFisher) and World Federation of Neurological Surgeons Scale (WFNS). Neurological outcome at poststroke 90 days was evaluated via the modified Rankin Scale (mRS). Univariate analysis and multivariate analysis were sequentially done to ascertain relationship between serum AIM2 levels, severity, delayed cerebral ischemia (DCI) and 90-day poor prognosis (mRS scores of 3-6). Patients, in comparison to controls, had a significant elevation of serum AIM2 levels at admission and at days 1, 2, 3, 5, 7 and 10 days after aSAH, with the highest levels at days 1, 2, 3 and 5. AIM2 levels were independently correlated with WFNS scores and mFisher scores. Significantly higher serum AIM2 levels were detected in patients with a poor prognosis than in those with a good prognosis, as well as in patients with DCI than in those without DCI. Moreover, serum AIM2 levels independently predicted a poor prognosis and DCI, and were linearly correlated with their risks. Using subgroup analysis, there were no significant interactions between serum AIM2 levels and age, gender, hypertension and so on. There were substantially high predictive abilities of serum AIM2 for poor prognosis and DCI under the receiver operating characteristic curve. The combination models of DCI and poor prognosis, in which serum AIM2, WFNS scores and mFisher scores were incorporated, showed higher discriminatory efficiencies than anyone of the preceding three variables. Moreover, the models are delineated using the nomogram, and performed well under the calibration curve and decision curve. Serum AIM2 levels, with a substantial enhancement during early phase after aSAH, are closely related to bleeding severity, poor 90-day prognosis and DCI of patients, substantializing serum AIM2 as a potential prognostic biomarker of aSAH.
摘要：
黑素瘤2（AIM2）中的缺失与神经炎症有关。这里,我们探讨了血清AIM2在人动脉瘤性蛛网膜下腔出血（aSAH）中的预后意义。我们连续招募了127名患者，其中56人不仅在入院时，而且在aSAH后第1、2、3、5、7和10天也同意采血。测量患者和56名健康对照者的血清AIM2水平。使用改良的Fisher量表(mFisher)和世界神经外科医师联合会量表(WFNS)评估疾病严重程度。通过改良的Rankin量表（mRS）评估卒中后90天的神经系统结局。依次进行单因素分析和多因素分析，以确定血清AIM2水平之间的关系，严重程度,迟发性脑缺血（DCI）和90天预后不良（mRS评分3-6）。患者,与控件相比，入院时和aSAH后第1、2、3、5、7和10天血清AIM2水平显着升高，在第1、2、3和5天最高。AIM2水平与WFNS评分和mFisher评分独立相关。在预后不良的患者中检测到的血清AIM2水平明显高于预后良好的患者，以及有DCI的患者比没有DCI的患者。此外，血清AIM2水平独立预测不良预后和DCI，并与其风险呈线性关系。使用亚组分析，血清AIM2水平和年龄之间没有显著的相互作用，性别,高血压等等。在受试者工作特征曲线下，血清AIM2对不良预后和DCI的预测能力很高。DCI与不良预后的组合模型，纳入血清AIM2、WFNS评分和mFisher评分，显示出比前面三个变量中的任何一个都更高的歧视性效率。此外，使用列线图描绘模型，并且在校准曲线和决策曲线下表现良好。血清AIM2水平，在aSAH后的早期阶段有实质性的增强，与出血严重程度密切相关，90天预后不良和DCI患者，证实血清AIM2作为aSAH的潜在预后生物标志物。
