Value of ischemia-modified albumin to assesment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage

CHEN Hua-xuan; ZHANG Yuan; WANG Lin; SONG Xu-dong; LIU Yi; FAN Run-jin

doi:10.13798/j.issn.1009-153X.2019.01.007

Abstract：Objective To investigate the value of ischemia-modified albumin (IMA) to the asessment of the cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (aSAH) and the relationship between the serum level of IMA and the prognosis in the patients with aSAH. Methods The clinical data of 198 patients with aSAH were analyzed retrospectively. The serum levels albumin cobalt binding (ACB) which indirectly reflected the serum levels of IMA were detected in all the patients, in whom the mean blood flow velocity (Vm) of middle cerebral artery (MCA) was determined by transcranial doppler 2~14 days after aSAH. Results Vm of MCA reached the peak 7~10 days after aSAH and then gradually decreased. The change in the serum levels of ACB was opposite to that in Vm of MCA. Vm of MCA was significantly higher 7~10 days after aSAH than that 2~6 days after aSAH (P<0.05), which was significantly higher than that 11~14 days after aSAH (P<0.05). The serum levels of ACB were significantly higher 11~14 days after aSAH than those 2~6 days after aSAH (P<0.05), which were significantly higher than that 7~10 days after aSAH (P<0.05). The higher the modified Fisher grade was, the higher the incidence of CVS was and the lower the serum level of ACB was (P<0.05). The serum level of ACB [(61.18± 5.91)U/ml] was significantly higher in the patients with good prognosis than that [(42.76±5.63)U/ml] in the patients with bad prognosis (P<0.05). Conclusions The serum level of ACB which is negatively correlated with the severity of CVS can be used to assess the degree of the CVS and prognosis in the patients with aSAH.