Predictive value of cerebrospinal fluid lactate combined with blood troponin Ⅰ and N-terminal brain natriuretic pep-tide precursor levels in the prognosis of aneurysmal subarachnoid hemorrhage
Objective:To investigate the predictive value of cerebrospinal fluid(CSF)lactate combined with blood troponin Ⅰ(CTnⅠ)and N-terminal brain natriuretic peptide precursor(NT-proBNP)levels in the prognosis of patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods:A total of 80 patients with aSAH were selected,and the lactate concentration in CSF on the 1st,3rd,and 7th day after the onset of the disease was detected and recorded,and the patients'blood routine,liver and kidney function,cardiac enzymes,blood gas analysis and other indicators were collected.After 3 months,the patients were followed up,and according to the Glasgow prognostic score,they were divided into good prognosis group and poor prognosis group.The above indexes of the two groups were compared,the receiver operating characteristic(ROC)curve was plotted,and the prognostic value of CSF lactate combined with blood CTnⅠ and NT-proBNp was analyzed.Results:Among the 80 patients,45 had a good prognosis and 35 had a poor prognosis.The CSF lactate concentration on the first and third day in the good prognosis group was significantly lower than that in the poor prognosis group(P＜0.05),and the ROC curve analysis showed that the predictive efficacy of the CSF lactate concentration on the first day was better than that on the third and 7th day,and the area under the curve(AUC)was 0.842,0.657 and 0.533,respectively.The blood urea nitrogen,blood glucose,pH,CTnⅠ and NT-proBNp in the good prognosis group were significantly lower than those in the poor prognosis group(P＜0.05),and the ROC curve analysis showed that the CSF lactate concentration combined with blood CTnⅠ and NT-proBNp on the first day had the highest prognostic evaluation performance,with an AUC of 0.94,a sen-sitivity of 88.6％and a specificity of 88.9％,which were better than urea nitrogen,blood glucose,pH and individual CTnⅠand NT-proBNp.Conclusion:The concentration of lactate in CSF combined with the levels of CTnⅠ and NT-proBNp in blood has a high predictive value in the prognosis of aSAH.
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