Abstract：
UNASSIGNED: To investigate the correlation of serum changes and markers of brain injury (BI) in cerebrospinal fluid (CSF) with postoperative cognitive dysfunction (POCD) in patients with cerebral aneurysmal subarachnoid haemorrhage (aSAH).
UNASSIGNED: 120 patients diagnosed with aSAH were included. 3 months after surgery, these patients were divided into a normal cognition group and a cognitive dysfunction (CD) group relying on the Montreal Cognitive Assessment (MoCA) Scale.
UNASSIGNED: The correlations were analysed between the serological changes and the levels of BI markers, such as neurofilament-light (NF-L) protein, Ubisquitin C-terminal hydrolase L1(UCH-L1), Glial Fibrillary Acidic Protein (GFAP), and neuron specific enolase (NSE) in patients after surgery. Hunt-Hess grading standard was employed to determine the severity of aSAH in patients. The mean values of NF-L, UCH-L1, GFAP, and NSE were (8.2 ± 4.3) pg/mL, (0.7 ± 0.3) ng/mL, (2.2 ± 0.4) ng/mL, and (48.5 ± 10.9) ng/mL in patients with severe aSAH, which were remarkably higher than those in patients with mild aSAH [(3.5 ± 0.7) pg/mL, (0.5 ± 0.2) ng/mL, (1.3 ± 0.7) ng/mL, (30.7 ± 8.2) ng/mL]. The sensitivity, specificity, and accuracy of the combined prediction of four detections for POCD were 90.80%, 84.20%, and 82.80%, respectively, which were greatly higher than those of four independent predictions (p < 0.05). The combined prediction effect of the four items, with the area under the curve (AUC) of 0.938 and the 95% confidence interval (CI) of 0.851-0.926.
UNASSIGNED: BI markers NF-L, UCH-L1, GFAP, and NSE could be utilized as predictors of POCD in patients with aSAH, deserving a reference value.
UNASSIGNED: 120 patients diagnosed with aSAH were included. 3 months after surgery, these patients were divided into a normal cognition group and a cognitive dysfunction (CD) group relying on the Montreal Cognitive Assessment (MoCA) Scale.
UNASSIGNED: The correlations were analysed between the serological changes and the levels of BI markers, such as neurofilament-light (NF-L) protein, Ubisquitin C-terminal hydrolase L1(UCH-L1), Glial Fibrillary Acidic Protein (GFAP), and neuron specific enolase (NSE) in patients after surgery. Hunt-Hess grading standard was employed to determine the severity of aSAH in patients. The mean values of NF-L, UCH-L1, GFAP, and NSE were (8.2 ± 4.3) pg/mL, (0.7 ± 0.3) ng/mL, (2.2 ± 0.4) ng/mL, and (48.5 ± 10.9) ng/mL in patients with severe aSAH, which were remarkably higher than those in patients with mild aSAH [(3.5 ± 0.7) pg/mL, (0.5 ± 0.2) ng/mL, (1.3 ± 0.7) ng/mL, (30.7 ± 8.2) ng/mL]. The sensitivity, specificity, and accuracy of the combined prediction of four detections for POCD were 90.80%, 84.20%, and 82.80%, respectively, which were greatly higher than those of four independent predictions (p < 0.05). The combined prediction effect of the four items, with the area under the curve (AUC) of 0.938 and the 95% confidence interval (CI) of 0.851-0.926.
UNASSIGNED: BI markers NF-L, UCH-L1, GFAP, and NSE could be utilized as predictors of POCD in patients with aSAH, deserving a reference value.
摘要：
目的探讨脑动脉瘤性蛛网膜下腔出血(aSAH)患者血清变化及脑脊液中脑损伤(BI)标志物与术后认知功能障碍(POCD)的相关性。纳入120例诊断为aSAH的患者。手术后3个月,根据蒙特利尔认知评估(MoCA)量表将这些患者分为认知正常组和认知功能障碍(CD)组.分析了血清学变化与BI标志物水平之间的相关性，如神经丝光（NF-L）蛋白，泛素C端水解酶L1（UCH-L1），胶质纤维酸性蛋白（GFAP），手术后患者的神经元特异性烯醇化酶（NSE）。采用Hunt-Hess分级标准确定患者aSAH的严重程度。NF-L的平均值，UCH-L1,GFAP,NSE为(8.2±4.3)pg/mL,(0.7±0.3)ng/mL,(2.2±0.4)ng/mL,严重aSAH患者的（48.5±10.9）ng/mL，显著高于轻度aSAH患者[(3.5±0.7)pg/mL,(0.5±0.2)ng/mL,(1.3±0.7)ng/mL,(30.7±8.2)ng/mL]。敏感性,特异性，四种POCD检测的联合预测准确率为90.80%，84.20%,和82.80%，分别,显著高于4个独立预测(P<0.05)。四项的综合预测效果，曲线下面积（AUC）为0.938，95%置信区间（CI）为0.851-0.926。BI标记NF-L,UCH-L1,GFAP,NSE可作为aSAH患者POCD的预测因子，值得参考的价值。
