Expression and significance of vWF, GMP-140 and ADAMTS13 in patients with aneurysmal subarachnoid hemorrhage

W.-H. Li , C.-J. Hui, H. Ju

Department of Neurosurgery, Affiliated Hospital of Qinghai University, Xining, Qinghai, China. zbviy665@sina.com

---

• Neurology

OBJECTIVE: The aim of this study was to investigate the role of the von Willebrand factor (vWF) in patients with aneurysmal subarachnoid hemorrhage (aSAH), platelet membrane glycoprotein-140 (GMP-140). The aim is also to discover the expression and clinical significance of von Willebrand factor (vWF) cleaving protease (ADAMTS13).

PATIENTS AND METHODS: 83 patients with aSAH were selected from January 2014 to December 2016. The patients were divided into cerebral vasospasm group (CVS group) (n = 37) and no convulsion group (non-CVS group) (n = 46); delayed cerebral ischemia group (DCI group) (n = 31) and non-delayed cerebral ischemia group (non-DCI group) (n = 52). Also, the different aneurysm diameter group included 43 patients in < 5 mm group, 29 patients in 5-10 mm group, 11 patients in > 10 mm group. The number of patients in the good prognosis group and the poor prognosis group were 49 and 34, respectively. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of vWF, GMP-140, and ADAMTS13 in plasma of aSAH patients, and the correlation between the indexes was analyzed.

RESULTS: The repeated measures analysis of variance showed that there was no significant difference in plasma vWF, GMP-140, and ADAMTS13 levels in each group of the aSAH patients (p < 0.05). The vWF level of the CVS group was higher than that of the non-CVS group on day 4 and day 10. The GMP-140 level of the CVS group was higher than that of the non-CVS group on day 1, day 4 and day 10. And the ADAMTS13 level was lower than that of the non-CVS group on day 1 and day 10. The difference was statistically significant (p < 0.05). The plasma vWF level of DCI group was higher than that of the non-DCI group on day 1 and day 4. The plasma GMP-140 level at day 4 was higher than that of the non-DCI group. The plasma ADAMTS13 level at day 1 was lower than that in the non-DCI group. The difference was significant (p < 0.05). The plasma vWF level in > 10 mm group was higher than that in < 5 mm group and 5-10 mm group at day 1 and day 4. The plasma vWF level in 5-10 mm group was higher than that in < 5 mm group at day 4. The plasma GMP-140 levels in > 10 mm group were higher than that in < 5 mm group and 5-10 mm group at day 1 and d ay 4. The plasma GMP-140 level in 5-10 mm group was higher than that in < 5 mm group at day 1. The plasma ADAMTS13 level in > 10 mm group was lower than that in < 5 mm group and 5-10 mm group on day 1. Moreover, the plasma ADAMTS13 level in 5-10 mm group was lower than that in < 5 mm group: p < 0.05. The plasma vWF level in the good prognosis group was lower than that in the poor prognosis group on day 4 and day 10. On day 1, day 4, and day 10, the level of GMP-140 was lower than that of the poor prognosis group. The ADAMTS13 level on day 1 and day 4 was higher than that in the poor prognosis group. The difference was statistically significant (p < 0.05). Pearson product moment correlation analysis showed that the plasma vWF level was positively correlated with GMP-140 at day 1 (r = 0.334, p < 0.05), negatively correlated with ADAMTS13 (r = -0.426, p < 0.05), and GMP-140 was negatively correlated with ADAMTS13 (r = -0.398, p < 0.05). At day 4, plasma vWF was positively correlated with GMP-140 (r = 0.278, p < 0.05), negatively correlated with ADAMTS13 (r = -0.311, p < 0.05), and GMP-140 was negatively correlated with ADAMTS13 (r = -0.235, p < 0.05). At day 10, there was no significant correlation between vWF, GMP-140, and ADAMTS13 (p > 0.05).

CONCLUSIONS: VWF, GMP-140, and ADAMTS13 were correlated with the diameters and prognoses of CVS, DCI, aneurysms. Combined detection can help to evaluate the condition of patients with aSAH, so as to provide a guide for clinical treatment and prognosis.

Free PDF Download