Correlation Between 20-hydroxyeicosatetraenoic Acid And Epoxy Eicosatrienoic Acid And Severity Of Aneurysmal Subarachnoid Hemorrhage

Objective:To compare the differences in serum and cerebrospinal fluid(CSF)levels of20-hydroxyeicosatetraenoic acid(20-HETE)and epoxy-eicosatrienoic acid(EET)in different groups of patients with aneurysmal subarachnoid hemorrhage(a SHA)in different grading systems.Consistency between the levels of 20-HETE and EET in preand intra-operative cerebrospinal fluid and the results of multiple stratification methods reflecting the severity of a SHA patients,and whether 20-HETE and EET can be used as accurate indicators to reflect the severity of a SHA patients,to provide reference for guiding early clinical intervention and improving patient prognosis.Methods:Eighty-seven patients with a SAH confirmed by head CT and CTA or DSA were enrolled in our department from May 2017 to August 2018.According to the collection of serum and cerebrospinal fluid,the patients were divided into serogroup(62 cases).The cerebrospinal fluid group(57 cases)consisted of two independent large groups,of which 38 patients had complete serum and cerebrospinal fluid specimens,which were shared by the two groups.Each patient in the two groups was divided into different subgroups according to Hunt-Hess classification,Fisher classification and WFNS classification.The general clinical data of all patients,including age,gender,duration of disease,intracranial aneurysm,etc.,were collected.The levels of 20-HETE and EET in preoperative serum and intraoperative cerebrospinal fluid were determined by enzyme-linked immunosorbent assay(ELISA).Statistical descriptions and inferences for all data were performed using SPSS 22.0software.All measures were described by mean ± standard deviation.The t test oftwo independent sample means was used to compare the data between the two groups.One-way ANOVA was used to compare multiple sets of data.The relationship between clinical indicators was determined.According to different types of data,Pearson or Spearman were used for correlation analysis,and the influencing factors were analyzed by multiple linear regression analysis.The test criteria were set to ?=0.05.When the statistical value was P < 0.05,the difference between the two groups was statistically significant.Results:1.Hunt-Hess classification group: preoperative serum 20-HETE level,there was no statistical difference between the multiple groups;preoperative serum EET level,there was only statistical difference between grade 4 and grade 5 group;intraoperative cerebrospinal fluid 20-HETE and EET levels,there was no statistical difference between the multiple groups.2.Fisher classification group: preoperative serum 20-HETE and EET levels,there was no statistical difference between the multiple groups;intraoperative cerebrospinal fluid 20-HETE level,there was only statistical difference between the second and fourth group;intraoperative cerebrospinal fluid EET levels,there was only statistical difference between the third and fourth group.3.WFNS classification group: preoperative serum 20-HETE and EET levels,there was no statistical difference between the multiple groups;intraoperative cerebrospinal fluid 20-HETE level,there was only statistical difference between the first and fifth group;intraoperative cerebrospinal fluid EET levels,there was no statistical difference between the multiple groups.Pearson correlation analysis: age and preoperative serum 20-HETE level showed a negative correlation trend(r=-0.082,P>0.05),and had no correlation with preoperative serum EET level(r=0.000,P>0.05).The level of 20-HETE in the intraoperative cerebrospinal fluid was negatively correlated(r=-0.084,P>0.05),and positively correlated with intraoperative cerebrospinal fluid EET level(r=0.296,P<0.05).5.Spearman correlation analysis: Hunt-Hess grade was positively correlated with preoperative serum 20-HETE and EET levels and intraoperative cerebrospinal fluid20-HETE and EET levels,with no statistical significance(r=0.213,r=0.148,r=0.232,r=0.167,P>0.05);Fisher grading was positively correlated with preoperative serum20-HETE and EET levels and intraoperative cerebrospinal fluid 20-HETE levels,no statistically significant(r=0.103,r=0.093,r=0.237,P>0.05),and positively correlated with intraoperative cerebrospinal fluid EET level(r=0.282,P<0.05);there was a negative correlation between WFNS grade and preoperative serum 20-HETE level,which was not statistically significant(r=-0.019,P>0.05),positive correlation with preoperative serum EET and intraoperative cerebrospinal fluid EET levels,no statistically significant(r=0.015,P>0.05,r=0.183,P> 0.05),it was positively correlated with intraoperative cerebrospinal fluid 20-HETE level(r=0.283,P<0.05).Conclusions:1.There was a positive correlation between the levels of 20-HETE and EET in the preoperative serum and intraoperative cerebrospinal fluid and the Hunt-Hess score.The concentration of the two biomarkers also increased with the increase of the score.But it is not statistically significant.The results of the Fisher grading and WFNS grading are the same as those of the Hunt-Hess grading.2.There was no significant difference in the levels of 20-HETE and EET between preoperative serum and intraoperative cerebrospinal fluid between different Hunt-Hess graded groups by one-way analysis of variance within the group.The results of the Fisher grading and WFNS grading are the same as those of the Hunt-Hess grading.By comparing the differences in 20-HETE and EET levels in serum and cerebrospinal fluid of a SHA patients with different grading systems,it is concluded that20-HETE and EET may not accurately assess the severity of aSHA patients.