脑脊液溶血磷脂酸含量与动脉瘤性蛛网膜下腔出血后脑积水的关系

目的探讨脑脊液溶血磷脂酸(LPA)含量与动脉瘤性蛛网膜下腔出血(aSAH)后脑积水的关系。方法选取经临床和辅助检查确诊的aSAH患者72例,于发病1、7、14、28d测定脑脊液中LPA含量,观察LPA含量与脑积水发生在时程上的相关性。结果 72例SAH患者中有23例(31.9%)发生脑积水,平均发生时间为(12.6±9.7)d。发病7d时aSAH患者脑脊液中LPA含量与发病1d时相比明显升高(P=0.002),14 d时开始下降,28d时与发病1d时相比差异无显著性(P=0.931)。发病7、14d时脑积水组脑脊液LPA含量显著高于无脑积水组(t1=11.15,P1=0.000;t2=4.90,P2=0.001),1、28d时两组相比差异无显著性(t1=1.126,P1=0.286;t2=0.726,P2=0.484)。结论脑脊液aSAH LPA水平在SAH后7～14d明显升高,且在时程上与脑积水的发生有明显关联;脑脊液LPA可能参与了aSAH后脑积水的形成,检测脑脊液LPA含量对预测aSAH后脑积水的发生可能具有重要意义。

Relationship between lysophosphatidic acid levels in cerebrospinal fluid and hydrocephalus after aneurysmal subarachnoid hemorrhage

Objective To explore the changes of lysophosphatidic acid(LPA) levels in cerebrospinal fluid(CSF) in patients with aneurismal subarachnoid hemorrhage(aSAH) and study its relationship with hydrocephalus.Methods Levels of LPA in CSF of 72 patients with aSAH diagnozed by clinical and accessory examinations were measured on day 1,7,14 and 28 after the symptoms onset.Time-phase correlation between the LPA levels and onset of hydrocephalus was observed.Results Of the 72 SAH patients,23 patients(31.9%) developed hydrocephalus,and the average onset time was(12.6±9.7) days.The LPA level on day 7 of the aSAH attack was obviously higher than that on day 1(P=0.002).LPA level began to decline on day 14.0n day 28,the LPA level was not significantly different from that of day 1 level(P=0.931).On day 7 and 14,the levels of LPA in the patients with hydrocephalus were significantly higher than those without hydrocephalus(t1=11.15,P1=0.000;t2=4.90,P2=0.001),on day 1 and 28,the differences being not significant(t1=1.126,P1=0.286;t2=0.726,P2=0.484).Conclusions The LPA levels in CSF increase markedly from day 7 to day 14 after the attack of aSAH,which is obviously associated with the occurrence of hydrocephalus on time course.LPA in CSF of patients with aSAH may be involved in the formation of hydrocephalus.To estimate the content of LPA in CSF may be of importance in predicting the occurrence of hydrocephalus after aSAH.