The Predictive Value Of Dynastic Concentration Variation Of IL-33 And SST2 In Early Cerebrospinal Fluid For The Prognosis Of Patients With Aneurysmal Subarachnoid Hemorrhage

Objective: Aneurysmal Subarachnoid Hemorrhage(a SAH)is a cerebrovascular disease with high morbidity and mortality,which seriously endangers human health and greatly reduces the life quality of patients.Therefore,it is great significance to explore the risk factors influencing the prognosis of a SAH and predict the prognosis of a SAH patients.It is the first time to evaluate the expression levels of IL-33 and sST2 in the early cerebrospinal fluid(CSF)of a SAH patients dynamically,analyze the difference between good prognosis group and poor prognosis group and evaluate the trend of IL-33 and sST2 dynamically.Ultimately,to evaluate whether IL-33 and ST2 in CSF can be used as early warning factors for poor prognosis and complications in patients with a SAHMethods: A total of 65 patients with a SAH who met the inclusion criteria in the Department of Neurosurgery,Jining First People’s Hospital from March2021 to September 2022 were selected.According to the Modified Rankin Scale(m RS),the patients were divided into poor prognosis group(m RS score≥3)and good prognosis group(m RS score<3).The CSF was continuously collected after surgery and the expression levels of IL-33 and sST2 in CSF were detected by ELISA.The Logistic model regression was used to explore the risk factors affecting prognosis of a SAH.The relationship between the two factors(IL-33,sST2)expression level and postoperative complications was further explored.Results:1.The IL-33 expression level in CSF of poor prognosis group was greatly higher than good prognosis group(P< 0.001).2.The sST2 expression level in CSF of poor prognosis group was notably higher than good prognosis group(P< 0.001).3.Multivariate Logistics regression analysis model showed gender(OR=4.59,95%CI:0.61-34.79,P=0.14),WFNS classification(OR=1.10,95%CI:0.43-2.83,P=0.83),Modified Fisher classification(OR=1.66,95%CI:0.72-3.81,P=0.23),Hunt-Hess classification(OR=2.25,95%CI:0.61-8.27,P=0.23),number of peripheral blood lymphocytes(OR=1.07,95%CI:0.39-2.91,P=0.90),total number of white blood cells in CSF(OR=0.14,95%CI:0.39-2.91,P=0.14),and aneurysm size(OR=6.74,95%CI:1.64-27.79,P=0.01)were risk factors for poor prognosis of a SAH.4.Mann-Whitney U test analysis showed that IL-33 and sST2 in CSF of a SAH patients were positively correlated with the occurrence of vein lower limb thrombosis.5.The results of ROC curve showed that the AUC value of sST2 expression level on the 1-5 days after operation with a SAH was 0.98,and the best critical value was 2939.45 pg/ml;the AUC value of IL-33 expression level on the 1-5 days after operation with a SAH was 0.89,and the best critical value was 342.01 pg/ml.Conclusion:1.The expression level of IL-33 and sST2 in CSF of a SAH patients with poor prognosis was considerably increased,suggesting that IL-33 and sST2 were involved in the pathological and physiological process of a SAH.2.IL-33 and sST2 in CSF are independent risk factors affecting the prognosis of a SAH patients,which can be used as potential biomarkers to predict the poor prognosis of a SAH.