Angiopoietin affects the prognosis in patients with aneurysmal subarachnoid hemorrhage

REN Qing; LI Jingjun; YIN Rui; WANG Xiaoliang; SUN Zhen; LU Ruichun; ZHANG Wei

Abstract：Objective The changes of Angiopoietins (Ang) level in patients with aneurysmal subarachnoid hemorrhage (aSAH) were analyzed,and the clinical value of Angiopoietim (Ang) level for evaluating prognosis in patients was investigated.Methods A prospective cohort study was adopted to collect 150 cases of aneurysmal subarachnoid hemorrhage (aSAH) patients admitted to the Third Affiliated Hospital of Qingdao University from January 2015 to March 2016 as the research object.Blood samples from 150 aSAH patients were collected at 8 h,24 h,72 h after an onset of SAH.The serum levels of Angiopoietin-1 (Ang-1),Angiopoietin-2 (Ang-2) and Tyrosine Kinase Receptors-2 (Tie-2) were measured by enzyme linked immunosorbent assay (ELISA),and angiopoietins levels of 150 healthy adults as control group.Repeated measures analysis of variance was used to compare different angiopoietins levels and trends in different prognosis group patients,and a Logistic regression model was used to analyze the relationship between the level of angiopoietins and prognosis outcome.Results The serum Ang-1,Ang-2 and Tie-2 expression level and Ang-1/Ang-2 ratio of aSAH patients with the prolongation of the time of onset showed varying increasing degrees,which were significantly higher than those in healthy control group (P ＜0.05).Ang-1 levels and Ang-1/Ang-2 ratio after the onset within 8 h was significantly higher than those of healthy control group (P ＜0.05).The serum Ang-1 expression level in SAH after 8 h,24 h and 72 h in aSAH patients with good prognosis were higher than those with the poor prognosis group;serum Ang-2 levels in SAH after 72 h in good prognosis group were better than those of poor prognosis group;the specific receptor Tie-2 levels in SAH after 24 h was higher than that of the poor prognosis group;the differences were statistically significant (P ＜0.05).Multivariate Logistic regression analysis showed that after the onset of SAH 8 h,24 h and 72 h the serum Aug-1 expression level [odd ratio (OR) (95％ confidence interval) were:1.128 (0.742～ 1.714),2.042 (1.151 ～3.623),3.893 (2.318 ～6.536)]and SAH after 24 h specific tyrosine kinase receptor Tie-2 levels [OR:2.400 (1.053 ～5.474)] were the influencing factors of the aSAH patients.Conclusion The serum Ang-1 level change trend of the aSAH patients is positively correlated with the prognosis.Abnormal levels of angiopoietins may affect the early brain injury after SAH and Ang-1 can be used as an important biomarker to detect the prognosis of aSAH.