Expression and prognostic value of ubiquitin carboxyl hydrolase L1 in the cerebrospinal fluid of patients with subarachnoid hemorrhage / 医学研究生学报

ABSTRACT

[Abstract ] Objective Ubiquitin carboxyl hydrolase L1(UCH-L1) is a neuron cytoplasm protein and increased UCH-L1 lev-el in cerebrospinal fluid( CSF) indicates brain injury.The study aimed to indentify UCH-L1 level in CSF of patients with subarachnoid hemorrhage(SAH) and assess the prognosis value of UCH-L1. Methods Retrospective analysis was made on 40 aneurismal SAH patients hospitalized in our department from August 2014 to February 2015.In the experiment group, CSF was taken by lumbar punc-ture in day1-day3, day5-day7, and day8-day10 after subarachnoid hemorrhage.In the control group, a single CSF sample was collect-ed during spinal anesthesia before surgery in 10 patients without neurologic disease.ELISA was applied to determine the concentration of UCH-L1 in CSF followed by comparison.Analysis was also made on relationship of the changes of UCH-L1 and modified rankins scale( MRS) 6 months later. Results CSF UCH-L1 concentrations in all SAH patients were significantly increased in day1-day3 ( P<0.05) after SAH, peaked in day5-day7 (P<0.01) and elevated un-til days 8-10 ( P<0.01 ) .MRS at 6 months showed a significant correlation with CSF levels of UCH-L1 in day5-day7 ( correlation co-efficient CC=0.691, P=0.001) and day8-day10 (CC=0.583,P=0.03), but not in days1-day3 (CC=0.364,P=0.08).SAH pa-tients with a good outcome at 6 months ( MRS<4) had much lower UCH-L1 levels in day5-day7 ( P=0.001) and day8-day10 ( P=0.041) than those with a poor outcome (MRS≥4).Higher UCH-L1 level at day5-day7 was a predictive marker of poor outcome in bi-nary logistic regression analysis (P=0.003); Conclusion The study suggests that increased CSF UCH-L1 level in day5-day7 after SAH is correlated with higher MRS and predicts an adverse clinical outcome 6 months after SAH.