Microglial activation for congtive impairment in aneurysmal subarachnoid hemorrhage

2024 Fiscal Year Final Research Report

• Project/Area Number: 22K09215
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56010:Neurosurgery-related
• Research Institution: Iwate Medical University
• Principal Investigator: Kubo Yoshitaka 岩手医科大学, 医学部, 非常勤医師 (00316366)
• Co-Investigator(Kenkyū-buntansha): 幸治 孝裕 岩手医科大学, 医学部, 准教授 (80382604)
• Project Period (FY): 2022-04-01 – 2025-03-31
• Keywords: くも膜下出血 / 外科的治療

Outline of Final Research Achievements

In this retrospective observational study. All patients underwent surgical clipping within 72 h of subarachnoid hemorrhage (SAH) onset. The Kaplan-Meier method using the log-rank test demonstrated that patients with an mRS of 4-5 at discharge had a significantly lower survival rate compared to those with an mRS of 0-3 at discharge (p<0.05). Univariate analysis revealed that the proportion of patients with Hunt and Hess grade and presence of surgical complications were significantly larger in the group with an mRS of 4-5 than in that with an mRS of 0-3 at discharge (p=0.0013 and 0.011, respectively). Multivariate analysis demonstrated that presence of surgical complications was the only independent predictor of poor outcomes (p=0.043, odds ratio [OR] 7.937, 95% confidence interval [CI] 1.061-59.38). Patients with H-H grade 2 and a good clinical condition should be to avoid surgical complications.

Free Research Field

脳血管障害

Academic Significance and Societal Importance of the Research Achievements

脳動脈瘤破裂によるくも膜下出血(SAH)高齢患者では、脳に大きな器質的病変がないにも関わらず、高次脳機能障害を認めることが少なくない。高次脳機能障害は患者の復職を阻み、また、患者への行政的サポートも希薄なのが現状であり、社会問題の１つと考えられる。現在、様々な炎症性サイトカインにより発現が誘導される新規炎症マーカーAの発現を動物研究と臨床研究において検証しているが、高齢SAH患者における上記の研究成果(Kubo Y et al. J Stroke Cerebrovasc Dis. 2022)はpilot studyとして学術的、社会的に意義があると考える。