the association between serum adhesion molecules and outcome in acute spontaneous intracerebral hemorrhage血清黏附分子之间的关系和结果在急性自发性脑出血.pdf

Wang et al. Critical Care 2011, 15:R284 /content/15/6/R284 RESEARCH Open Access The association between serum adhesion molecules and outcome in acute spontaneous intracerebral hemorrhage 1,2 3 1,4 1 1 5 Hung-Chen Wang , Wei-Che Lin , Yu-Jun Lin , Cheng-Shyuan Rau , Tsung-Han Lee , Wen-Neng Chang , Nai-Wen Tsai5, Ben-Chung Cheng4,6, Chia-Te Kung7 and Cheng-Hsien Lu4,5* Abstract Introduction: Serum concentrations of adhesion molecules may be connected to the pathogenesis of secondary brain injury after spontaneous intracerebral hemorrhage (ICH). This study posits the hypothesis that levels of adhesion molecules substantially increase after ICH and are decreased thereafter, and that they can predict treatment outcomes. Methods: Two hundred and thirty-nine blood samples were collected from 60 consecutive patients admitted within 24 hours after onset of spontaneous ICH and 60 blood samples were collected from 60 volunteers. Additional samples were obtained on Days 4, 7, 10, and 14 after onset of ICH regardless of clinical deterioration. Results: Upon discharge, the therapeutic outcomes of the 60 spontaneous ICH cases based on the modified Rankin Disability Scale (mMRS) showed that 17 had no disability while 8.3% developed delayed cerebral infarction (DCI). Statistical analysis of adhesion molecules between patient groups with good outcome (mMRS = 0 or 1) and poor outcome (mMRS ≥2) revealed significant differences in diabetes mellitus (P=0.049), hyperlipidemia (P=0.012), mentality change (P=0.043), ICH volume and intraventricular hemorrhage on admission (P=0.036 and 0.006, respectively), Glasgow Coma Scale (GCS) on admission (P≤0.001), neuro-surgical intervention (P=0.003), and sE- sele