ABSTRACT
Objective To investigate the clinical risk factors of delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods From January 2015 to April 2016,106 consecutive patients with aSAH treated with endovascular embolization at the Department of Neurosurgery,Nanjing General Hospital of Nanjing Military Command were enrolled retrospectively.The patients were divided into either a DCI group (n =34) or a non-DCI group (n =72) according to whether the occurrence of DCI.The general information of patients were collected,including sex,age,Hunt-Hess grade,modified Fisher grade,world federation of neurosurgical societies (WFNS) grade,acute cerebral edema,early (bleeding 1-3 d) hypoalbuminemia,and hypohemoglobinemia.Univariate and multivariate Logistic regression analyses were used to analyze the risk factors for occurrence of DCI.Results The incidence of DCI was 32.1％ (34/106).The Hunt-Hess grade ≥ Ⅲ,modified Fisher grade ≥ Ⅲ,WFNS grade ≥ Ⅳ,acute cerebral edema,the incidences of hypoalbuminemia and hypohemoglobinemia in the DCI group were higher than those in the non-DCI group.There were significant differences between the 2 groups (all P ＜ 0.05).There were no significant differences in the ratios of sex,age ≥ 55 years,hypertension,diabetes and hyponatremia between the 2 groups (all P ＞ 0.05).In univariate analysis,the Hunt-Hess grade ≥ Ⅲ grade,modified Fisher grade ≥ Ⅲ,WFNS grade ≥ Ⅳ on admission,and hypoalbuminemia were used as the independent variables for multivariate analysis,the results showed that WFNS grade ≥ Ⅳ (OR,8.02;95 ％ CI 2.41-26.70),modified Fisher grades ≥ Ⅲ (OR,4.44;95％ CI 1.38-14.32),and hypoalbuminemia at day 1-3 (OR,5.42;95％ CI 1.40-20.76) were the independent risk factors for occurring DCI in patients with aSAH (all P ＜ 0.05),and the Hunt-Hess grade ≥ Ⅲ was not the risk factor for occurring DCI in patients with aSAH (OR,1.86;95％ CI 0.39-8.88,P ＞ 0.05).Conclusion The patients with hypoalbuminemia,WFNS grade≥Ⅳ on adrnission,and modified Fisher grade ≥ Ⅲ may were the independent risk factors DCI after aSAH,and the clinical diagnosis and treatment should attach great importance to.
ABSTRACT
MicroRNA (miRNA),which is closely related to the occurrence and development of tumors,may act as oncogenes or tumor suppressor genes by regulating target genes-related signal transduction pathways,such as epidermal growth factor receptor pathway,phosphatidylinositol 3-kinase-protein kinase B pathway and Ras signal transduction pathway.It is believed that miRNAs have broad application prospects in the treatment of tumors.