The Predictive Value of PKC and ET-1 Levels in Cerebrospinal Fluid for Vasospasm and Prognosis in Patients with Aneurysmal Subarachnoid Hemorrhage

Hailong Li, Donghua Li, Mi Li, Zehong Hu Department of Neurosurgery, Panzhihua Central Hospital, Panzhihua City, Sichuan Province, People’s Republic of ChinaCorrespondence: Hailong Li, Department of Neurosurgery, Panzhihua Central Hospital, No. 34, Yikang Street, East District, Panzhihua City, Sichuan Province, 617000, People’s Republic of China, Email lihailongdr@21cn.comObjective: To analyze the predictive value of protein kinase C (PKC) and endothelin-1 (ET-1) in cerebrospinal fluid for vasospasm and prognosis in patients with aneurysmal subarachnoid hemorrhage (ASH).Methods: One hundred and forty-eight ASH patients hospitalized in our hospital during February 2019 to February 2022 were optioned as observation subjects. These subjects were graded into good prognosis group (mRS score 0– 2, n = 102) and poor prognosis group (mRS score 3– 6, n = 46) according to the Rankin Revised Scale Score (mRS) after 6 months of follow-up. Cerebrospinal fluid was collected from patients to detect the content of ET-1 and PKC. The prognostic factors were analyzed using multifactorial logistic regression. The predictive value was assessed using receiver operating characteristic (ROC) curve.Results: The patients with poor prognosis had a higher age level and a higher proportion of ≥ 2 aneurysms, aneurysm diameter ≥ 6 mm, cerebral vasospasm, and Hunt-Hess grade ≥III than those with good prognosis (P < 0.05). The patients with poor prognosis had higher content of PKC and ET-1 than those with good prognosis (P < 0.05). Age, aneurysm diameter ≥ 6 mm, cerebral vasospasm, Hunt-Hess classification ≥grade III, PKC and ET-1 were all risk factors related to the prognosis of ASH (P < 0.05). The area under the curve (AUC) of PKC and ET-1 for diagnosing poor prognosis of ASH was 0.803 and 0.720, respectively. The AUC of the combined detection was 0.873 (P < 0.05). Patients with cerebrovascular spasm had higher content of PKC and ET-1 than those without (P < 0.05). The AUC of PKC and ET-1 for diagnosing cerebral vasospasm in ASH was 0.891 and 0.816, respectively, which was 0.932 for combined detection (P < 0.05).Conclusion: The combination of PKC and ET-1 in cerebrospinal fluid had certain value in predicting the poor prognosis of patients with ASH.Keywords: aneurysmal subarachnoid hemorrhage, prognosis, cerebrospinal fluid, PKC, ET-1, diagnosis