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已发表论文
入院时血清受体相互作用蛋白激酶 1 作为动脉瘤性蛛网膜下腔出血严重程度的生物标志物及预后因素
Authors Wang Y, Ye J, Huang J, Ye H, Zhang Z, Cai Y, Su C
Received 25 July 2025
Accepted for publication 11 October 2025
Published 17 October 2025 Volume 2025:18 Pages 6279—6299
DOI https://doi.org/10.2147/IJGM.S556157
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Redoy Ranjan
Yanfeng Wang,1,* Jianping Ye,2,* Jing Huang,3 Huifeng Ye,4 Zhixing Zhang,5 Yong Cai,6 Chang Su1
1Department of Neurosurgery, Lishui Hospital of Wenzhou Medical University, Lishui People’s Hospital, Lishui, Zhejiang, People’s Republic of China; 2Department of Intensive Care Unit, Lishui Hospital of Wenzhou Medical University, Lishui People’s Hospital, Lishui, Zhejiang, People’s Republic of China; 3Department of Neurosurgery, Longquan People’s Hospital, Lishui, Zhejiang, People’s Republic of China; 4Department of Nursing, Songyang County Hospital of Traditional Chinese Medicine, Lishui, Zhejiang, People’s Republic of China; 5Department of Neurosurgery, Jinyun County Hospital of Traditional Chinese Medicine, Lishui, Zhejiang, People’s Republic of China; 6Department of Neurosurgery, First People’s Hospital of Linping District, Hangzhou, Zhejiang, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chang Su, Department of Neurosurgery, Lishui Hospital of Wenzhou Medical University, Lishui People’s Hospital, Lishui, Zhejiang, People’s Republic of China, Email suchang530@126.com
Objective: Receptor-interacting protein kinase-1 (RIPK1), a regulator of necrotic apoptosis, is involved in acute brain injury. This study was designed to investigate whether serum RIPK1 levels are related to severity and poor clinical outcomes after aneurysmal subarachnoid hemorrhage (aSAH).
Methods: In this multicenter prospective cohort study of 224 patients with aSAH and 100 controls, severity appraisal was completed by applying the Hunt-Hess and modified Fisher (mFisher) gradings, and neurological function was evaluated by using the modified Rankin Scale (mRS) at post-aSAH three months. A single blood-drawing was performed at admission of patients, and the enzyme-linked immunosorbent assay was used to measure serum RIPK1 levels. Multivariate analyses were adopted to determine relation of serum RIPK1 levels with severity, delayed cerebral ischemia (DCI) and 3-month poor prognosis following aSAH (mRS 3– 6).
Results: Median interval time between symptom ictus and blood drawings was 6.9 h (lower-upper quartiles, 4.8– 11.3 h). Serum RIPK1 levels were significantly elevated in aSAH patients compared to controls and were independently associated with Hunt-Hess and mFisher scores. Higher RIPK1 levels correlated with increased risk of DCI and poor 3-month outcomes. The two respective combined predictive models incorporating RIPK1, Hunt-Hess, and mFisher scores demonstrated superior prognostic accuracy compared to each variable alone.
Conclusion: Elevated serum RIPK1 levels after aSAH are closely associated with disease severity, and can effectively predict the occurrence of DCI and poor prognosis at 3 months post-aSAH. Thus, serum RIPK1 may be a potential prognostic biomarker of aSAH.
Keywords: aneurysmal subarachnoid hemorrhage, receptor-interacting protein kinase-1, disease severity, delayed cerebral ischemia, poor prognosis
1Department of Neurosurgery, Lishui Hospital of Wenzhou Medical University, Lishui People’s Hospital, Lishui, Zhejiang, People’s Republic of China; 2Department of Intensive Care Unit, Lishui Hospital of Wenzhou Medical University, Lishui People’s Hospital, Lishui, Zhejiang, People’s Republic of China; 3Department of Neurosurgery, Longquan People’s Hospital, Lishui, Zhejiang, People’s Republic of China; 4Department of Nursing, Songyang County Hospital of Traditional Chinese Medicine, Lishui, Zhejiang, People’s Republic of China; 5Department of Neurosurgery, Jinyun County Hospital of Traditional Chinese Medicine, Lishui, Zhejiang, People’s Republic of China; 6Department of Neurosurgery, First People’s Hospital of Linping District, Hangzhou, Zhejiang, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chang Su, Department of Neurosurgery, Lishui Hospital of Wenzhou Medical University, Lishui People’s Hospital, Lishui, Zhejiang, People’s Republic of China, Email suchang530@126.com
Objective: Receptor-interacting protein kinase-1 (RIPK1), a regulator of necrotic apoptosis, is involved in acute brain injury. This study was designed to investigate whether serum RIPK1 levels are related to severity and poor clinical outcomes after aneurysmal subarachnoid hemorrhage (aSAH).
Methods: In this multicenter prospective cohort study of 224 patients with aSAH and 100 controls, severity appraisal was completed by applying the Hunt-Hess and modified Fisher (mFisher) gradings, and neurological function was evaluated by using the modified Rankin Scale (mRS) at post-aSAH three months. A single blood-drawing was performed at admission of patients, and the enzyme-linked immunosorbent assay was used to measure serum RIPK1 levels. Multivariate analyses were adopted to determine relation of serum RIPK1 levels with severity, delayed cerebral ischemia (DCI) and 3-month poor prognosis following aSAH (mRS 3– 6).
Results: Median interval time between symptom ictus and blood drawings was 6.9 h (lower-upper quartiles, 4.8– 11.3 h). Serum RIPK1 levels were significantly elevated in aSAH patients compared to controls and were independently associated with Hunt-Hess and mFisher scores. Higher RIPK1 levels correlated with increased risk of DCI and poor 3-month outcomes. The two respective combined predictive models incorporating RIPK1, Hunt-Hess, and mFisher scores demonstrated superior prognostic accuracy compared to each variable alone.
Conclusion: Elevated serum RIPK1 levels after aSAH are closely associated with disease severity, and can effectively predict the occurrence of DCI and poor prognosis at 3 months post-aSAH. Thus, serum RIPK1 may be a potential prognostic biomarker of aSAH.
Keywords: aneurysmal subarachnoid hemorrhage, receptor-interacting protein kinase-1, disease severity, delayed cerebral ischemia, poor prognosis