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Báo cáo y học: "Insulin like growth factor-I in acute subarachnoid hemorrhage: a prospective cohort study"

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Insulin like growth factor-I in acute subarachnoid hemorrhage: a prospective cohort study. | Bendel et al. Critical Care 2010 14 R75 http ccforum.eom content 14 2 R75 c CRITICAL CARE RESEARCH Open Access Insulin like growth factor-I in acute subarachnoid hemorrhage a prospective cohort study Stepani Bendel 1 Timo Koivisto2 Olli-Pekka Ryynănen3 Esko Ruokonen1 Jarkko Romppanen4 Vesa Kiviniemi5 and Ari Uusaro1 Abstract Introduction Neuroendocrine deficiencies may affect recovery after aneurysmal subarachnoid hemorrhage aSAH . Insulin like growth factor-I IGF-I regulates neuronal growth and apoptosis in ischemic stroke. Our study was designed to a characterize the behavior of serum IGF-I and growth hormone GH in the acute and late phases after aSAH reflecting possible pituitary gland function and b evaluate the association between IGF-I and morbidity assessed by Glasgow outcome scale GOS and health related quality of life HRQoL in patients with aSAH. Methods In this prospective cohort study patients with aSAH n 30 were compared to patients who underwent elective aneurysm surgery n 16 . Serum GH and IGF-I concentrations were measured daily for five controls or seven aSAH days and at three months. GOS and 15d HRQoL was measured at three months. A mixed models method was used for testing between the groups. For factors possibly affecting HRQoL in aSAH patients we constructed a Bayesian predicting model using a P-course Bayesian classifier. Results The mean IGF-I concentrations for days one to five were 8.1 3.5 nmol l in patients with aSAH and 11.2 3.1 in the control group P 0.01 . No corresponding difference was found at three months. Serum GH concentrations were similar in both patient groups. Severity of the aSAH did not affect serum IGF-I concentrations. Patients with GOS 4 had lower IGF-I concentrations and lower HRQoL than patients with GOS 5 P 0.02 and 0.003 respectively . The 15d HRQoL was 0.81 0.16 in patients with aSAH and 0.86 0.09 in control patients P 0.24 . In the Bayesian model the use of statins prior to aSAH hyponatremia high maximal sequential .

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