頁籤選單縮合
題名 | Validation of CSF Marker to Predict Shunt-Dependence Patients after Aneurysmal SAH=用來預測動脈瘤性蛛網膜下腔出血後病人依賴引流裝置之腦脊髓液標記物的校驗 |
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作 者 | 湯其暾; 曾冠穎; 許師偉; 馬辛一; 劉敏英; | 書刊名 | 中華民國重症醫學雜誌 |
卷期 | 12:3 2011.09[民100.09] |
頁次 | 頁105-111 |
分類號 | 415.384 |
關鍵詞 | 血腦脊髓液屏障; 動脈瘤性蛛網膜下腔出血; 引流裝置依賴性; Blood-CSF barrier; Transthyretin; Aneurysmal SAH; Shunt-dependence; |
語文 | 英文(English) |
中文摘要 | 目的:血腦脊髓液屏障( blood-CSF barrier)的理論已被提出作為臨床疾病的闡釋。在這次研究中,我們檢測腦脊髓液裡的 transthyretin在動脈瘤性蛛網膜下腔出血(aSAH)病人中需依賴分流手術的可能角色。 材料和方法:在 5年期間( 2004-2009年),有 147名患者( 79名女性和 68名男性),平均年齡 58.2歲(範圍從 43至 79歲)罹患蛛網膜下腔出血。其中 81人(次分為外傷性,動脈瘤性和特發性三組)因腦脊髓液低流狀態(hypodynamic)發展成慢性水腦症。 結果:三組病人的 transthyretin濃度進行了統計比較。我們應用簡單線性回歸分析其臨床相關性。在創傷性和動脈瘤性的病人利用腦脊髓液 transthyretin作為預測繼發動脈瘤性水腦有顯著的統計意義(P值≦ 0.05)。 結論:在我們的研究中,腦脊髓液 transthyretin可能是一個與預測需不需依賴腦脊髓液分流的重要標計物。至於實際應用在動脈瘤病人情況下,更需要前瞻性隨機對照研究以驗證其可靠性。 |
英文摘要 | Purpose: A theory of blood-CSF barrier has been postulated for interpretations of clinical diseases. The microenvironment is enriched in specific molecules following physiological rhythms. In this study, we examined the possible role of CSF transthyretin in the patients who required shunt dependences after episodes of aneurysmal sub-arachnoid hemorrhage (aSAH). Materials and Methods: Over a 5-year period (2004-2009), there were 147 patients (79 females and 68 males) with a mean age of 58.2 years (range from 43 to 79 years) suffered from subarachnoid hemorrhage. 81 of them (subcategorized by traumatic, aneurysmal and idiopathic groups) developed altered CSF hypodynamic state contributing to the chronic hydrocephalus. The CSF samples were collected during their first shunt surgeries. The transthyretin was quantified to validate its clinical relevance to shunt dependence. results: The transthyretin levels in three-group patients were statistically compared. The simple linear regression analysis was applied to our proposed correlation. The Pearson correlations coefficient revealed a significantly positive result (R²=0.72 in traumatic group and R²=0.86 in aneurismal group). There is significantly statistical meaning for tramatic and aneurysmal patients with regard to tracing CSF transthyretin to predict the intent-to-treated hydrocephalus secondary to aSAH (Both p-value≦0.05). Conclusions: In our study, the CSF transthyretin could be a important CSF maker to correlate the clinical shunt-dependence. As specific for aneurysmal cases, a prospective randomized study is further required to verify its reliability rather than traumatic and idiopathic occasions. |
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