Correlation Analysis Between Early Damage Of Blood-brain Barrier And Neurological Dysfunction In Patients With Aneurysmal Subarachnoid Hemorrhage

Objective:To evaluate the correlation between blood brain barrier(BBB)damage and clinical prognosis in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods:A retrospective analysis of 40 patients with intracranial aneurysms treated in our hospital from February 2019 to November 2019 was divided into two groups,of which 32 patients with aSAH underwent intracranial aneurysm clipping as the experimental group and eight patients with unruptured aneurysm underwent intracranial aneurysm clipping as the control group.In the experimental group,on the 3rd day(48-72 hours)of the disease,2 ml of lateral ventricle cerebrospinal fluid specimens were taken during craniotomy aneurysm clipping,and 2 ml of venous blood was drawn.The level of albumin(Alb)in plasma and cerebrospinal fluid were measured by bromcresol green method and rate scattering turbidimetry method,and its quotient(QAlb)was calculated as an indicator of blood-brain barrier permeability.In the control group,subarachnoid cerebrospinal fluid and venous blood samples were taken from the patients during the operation.The experimental methods were the same as before.GCS score and Hunt-Hess grade were used to assess the neurological status of patients at admission;fisher classification was used to assess intracranial hemorrhage;modified Rankin score was used to assess the neurological status of patients at 3 months after discharge.Predicte the clinical prognosis of patients with ROC survival curve.Results:In the current study,56% of patients with aSAH had a poor prognosis,and the control group had no poor prognosis.The QAlb value in the cerebrospinal fluid and venous blood samples of the experimental group was significantly higher than that of the control group.The QAlb was 3.47 ± 2.24,7.86 ± 0.39,18.81 ± 6.22,37.84 ± 6.03 in turn.According to statistical analysis,the higher the QAlb value,the more severe the blood-brain barrier destruction of the patient,and the worse the clinical prognosis of the patient.Factors such as age,bleeding volume and neurological status at admission were positively correlated with the degree of BBB destruction.The degree of BBB damage can reflect the clinical prognosis of patients(ROC area under the curve = 0.914,P <0.001).Conclusion:The QAlb value can be used to identify the degree of BBB damage in aSAH patients at an early stage,which can be used as one of the biological markers to evaluate neurological dysfunction in aSAH patients.This study is of great significance for predicting the blood-brain barrier damage in patients with aSAH at the early stage of bleeding and for assessing the degree of neurological recovery in aSAH.