Endothelin-1 levels in serum and cerebrospinal fluid after vasospasm following spontaneous subarachnoid haemorrhage

Yıl 2019, Cilt: 44 Sayı: 2, 334 - 340, 30.06.2019

Emre Bilgin Kadir Oktay Semih Kıvanç Olguner Gökhan Çavuş Vedat Açık Ali Arslan Metin Tuna

https://doi.org/10.17826/cumj.481237

Öz

Purpose: The aim of the present study was to
analyse endothelin-1 levels in serum and cerebrospinal fluid samples in
patients with subarachnoid haemorrhage and evaluated the effects on vasospasm.

Material and
Methods: The patients were
selected among those who referred to intensive care unit of neurosurgery
department within several hours following subarachnoid
haemorrhage. Subarachnoid haemorrhage
was diagnosed through cerebral computed
tomography and lumbar punction. First neurological examinations of the
patients were evaluated according to Hunt-Hess classification and the blood
quantity was detected by cerebral computed
tomography according to Fisher classification.

Results: Serum and cerebrospinal fluid samples of 20 patients enrolled into the
present study were collected at days 1, 3, 5, and 7 after subarachnoid haemorrhage. Ten individuals
without any vascular diseases, nervous system trauma or inflammatory disease
were enrolled into the study as the control group. Samples were analyzed
through micro-ELISA method and endothelin-1 levels in the serum and cerebrospinal fluid were detected. According
to Hunt-Hess classification, 6 patients were evaluated as Stage I, 10 patients
as Stage II, 2 patients as Stage III and 2 patients as Stage IV. Seventeen
patients were detected as Stage II whereas 3 patients were Stage IV according to
Fisher classification. Vasospasm was detected in cases 3, 6, 11 and 18 by
digital subtraction angiography.

Conclusion: It was determined
that as the Fisher and Hunt-Hess classifications increased, the risk of
cerebral vasospasm increased. The present study revealed that endothelin-1
levels increase after subarachnoid
haemorrhage and Endothelin-1 particularly may play an important role in
the vasospasm following spontaneous subarachnoid
haemorrhage.

Anahtar Kelimeler

Endothelin-1, subarachnoid haemorrhage, vasospasm

Spontan subaraknoid kanamayı takiben gelişen vazospazm sonrası serum ve serebrospinal sıvıda endotelin-1 düzeyleri

Öz

Amaç: Bu çalışmanın amacı subaraknoid kanamalı hastalarda serum ve beyin omurilik
sıvısı örneklerinde endotelin-1 düzeylerini analiz etmek ve vazospazm
üzerindeki etkilerini değerlendirmektir.

Gereç ve Yöntem: Hastalar subaraknoid kanamayı takiben birkaç saat içinde beyin cerrahisi
bölümünün yoğun bakım ünitesine yatırılan hastalar arasından seçildi.
Subaraknoid kanama teşhisi serebral bilgisayarlı tomografi ve lomber ponksiyon
ile konuldu. Hastaların
ilk nörolojik muayeneleri Hunt-Hess sınıflamasına göre değerlendirildi ve
serebral bilgisayarlı tomografi ile tespit edilen kan miktarları Fisher
sınıflamasına göre derecelendirildi.

Bulgular: Çalışmaya dahil edilen 20
hastanın serum ve beyin omurilik sıvısı örnekleri subaraknoid kanamanın
ardından 1, 3, 5 ve 7. günlerde toplandı. Kontrol
grubu olarak herhangi bir kranial vasküler hastalığı, sinir sistemi travması
veya enflamatuar hastalığı olmayan 10 hasta çalışmaya dahil edildi. Örnekler mikro-ELISA yöntemi ile analiz edildi ve
serumda ve beyin omurilik sıvısında endotelin-1 düzeyleri tespit edildi. Hunt-Hess sınıflamasına göre; 6 hasta Evre I, 10 hasta
Evre II, 2 hasta Evre III ve 2 hasta Evre IV olarak değerlendirildi. Fisher sınıflamasına göre; 17 hasta Evre II, 3 hasta
Evre IV olarak saptandı. Vasospazm, 3, 6, 11 ve 18 numaralı olgularda dijital
subtraksiyon anjiyografi ile tespit edildi.

Sonuç: Yaptığımız çalışmada, Fisher ve Hunt-Hess
sınıflandırmalarında evre arttıkça serebral vazospazm riskinin arttığı
saptanmıştır. Ayrıca endotelin-1 düzeylerinin subaraknoid kanamadan sonra
arttığı ve artan endotelin-1 seviyelerinin spontan subaraknoid kanamayı takiben
vazospazmda önemli bir rol oynayabileceği ortaya konmuştur.

Anahtar Kelimeler

Endotelin-1, subaraknoid kanama, vazospazm

Kaynakça

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