Value of cerebrospinal fluid lactic acid in prognoses of aneurysmal subarachnoid hemorrhage
10.3760/cma.j.cn115354-20191214-00748
- VernacularTitle:脑脊液乳酸在动脉瘤性蛛网膜下腔出血术后转归中的预测价值研究
- Author:
Zhi YAN
1
;
Haibo LIU
;
Tianquan ZHAO
;
Enren WANG
Author Information
1. 成都医学院第一附属医院神经外科，成都 610500
- Keywords:
Subarachnoid hemorrhage;
Intracranial aneurysm;
Cerebrospinal fluid lactic acid;
Lactic acid clearance rate
- From:
Chinese Journal of Neuromedicine
2020;19(5):483-487
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the value of cerebrospinal fluid (CSF) lactic acid level and lactic acid clearance rate in arterial blood in predicting the prognoses of patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods:A total of 70 patients with aSAH admitted to our hospital from August 2018 to October 2019 were selected. The clinical data and biochemical indexes of cerebrospinal fluid were collected, and the study subjects were re-examined and followed up 3 months after operation. The patients were divided into good prognosis group and poor prognosis group according to modified Rankin scale (mRS) scores. Univariate analysis was used to compare the clinical data and biochemical examination indicators of patients from the two groups. Multivariate Logistic regression analysis was used to screen the independent factors affecting the prognoses of the patients.Results:There were 51 patients in the good prognosis group and 19 patients in the poor prognosis group. The patients in the good prognosis group had significantly younger age, significantly higher Glasgow coma scale (GCS) scores, and significantly better Hunt-Hess grading and modified Fisher classification distribution than those in the poor prognosis group ( P<0.05). The contents of CSF lactic acid at 0-24 h and 48-72 h after surgery in the good prognosis group were significantly lower than those in the poor prognosis group ( P<0.05); the percentages of patients with CSF lactic acid≤3.28 mol/L and patients with CSF lactic acid clearance≥10% were significantly higher than those of poor prognosis group ( P<0.05). Multivariate Logistic regression analysis showed that age ( OR=1.089, 95%CI: 1.000-1.186, P=0.049), GCS scores ( OR=5.610, 95%CI: 1.136-27.696, P=0.034), Hunt-Hess grading ( OR=3.921, 95%CI: 1.084-14.175, P=0.037), and CSF lactic acid clearance rate ( OR=9.821, 95%CI: 1.278-75.483, P=0.028) were independent factors affecting the prognoses of aSAH patients. Conclusion:CSF lactic acid clearance rate can predict the postoperative outcome of aSAH patients; patients with CSF lactic acid clearance rate≥10% have a good prognosis.
