الفهرس 
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Abstract
Intracerebral hemorrhage (ICH) is a common cerebrovascular disease associated with high morbidity and mortality rates (Pinho et al., 2019), and accounts for approximately 10-20% of all strokes incidence (Sacco et al., 2009).
Intracerebral hemorrhage commonly affects the basal ganglia, the thalamus, the brain stem (predominantly the pons), and the cerebellum as a result of ruptured vessels affected by hypertension-related degenerative changes (Qureshi et al., 2001).
Osteopontin (OPN), also named secreted phosphoprotein 1, is a member of the small integrinbinding ligand N-link glycoprotein family (Butler, 1989).
It exsists in a negligible quantity in healthy brains, but it can regulate inflammation, apoptosis, tissue remodeling, and cell survival in the field of acute brain injury, and worked protectively against neuroinflammation, blood-brain barrier disruption, neuronal apoptosis, and cerebral vasospasm (Kataoka et al., 2018).
In clinical settings, plasma OPN concentrations were correlated with Glasgow coma scale scores and mortality after pediatric traumatic brain injury (GAO et al., 2019). Such data indicates that OPN may be a good blood biomarker in acute brain injury (Li, et al., 2019).
The aim of this study is to explore the potential role of plasma Osteopontin level as a blood biomarker in intracerebral hemorrhage patients and its relation to severity at presentation and functional outcome after 3 months.
The present study is a case control study that was conducted on 40 patients diagnosed as having intracerebral hemorrhage and admitted in Stroke Unit, Beni-Suef University Hospital and 40 age and sex matched controls. Both patients and controls were recruited from March 2021 to August 2021. All participants were hospitalized from the first day of onset of ICH symptoms.
Patients were subjected to the following:
I. Clinical assessment:
1- History taking
2- Medical examination
3-National Institute of Health Stroke Scale (NIHSS): After admission in stroke unit , at day 1 and at day 90 from stroke onset.
4- Modified Rankin Scale: after 90 days.
II. Laboratory assessment:
1. Routine Labs
Including : Random blood sugar, (CBC), (INR), (Triglycerides,HDL)
2. Measurement of plasma OPN Blood samples of both ICH patients
and controls
III. Radiological assessment: CT (Computed Topography).
The results of this work can be summarized in these points:
- Serum osteopontin levels were much higher in patients with ICH compared to healthy controls (P-value <0.001)
- Serum osteopontin level when measured within 24 hours of ICH onset was correlated significantly with the ICH severity according to (NIHSS) on admission (p-value 0.004).
- Patients with moderate to severe ICH had higher osteopontin level than patients with mild ICH (P-value 0.004).
- There was significant correlation between NIHSS score after 3 months and serum OPN level (p-value =0.045).
- Serum osteopontin level has statistically positive correlation with the volume of haemorrhage measured on CT brain (P-value 0.004).
- Osteopontin level was much higher in ICH patients with unfavorable outcome (mRS=3-6) than patients with favorable outcome (mRS=0- 2) (P-value< 0.001).
- there was a significant positive correlations between osteopontin level and patient’s age ( p-value 0.035)
- There was statistically significant difference in serum OPN level in hypertensive ICH patients when compared to patients without hypertension (p-value=0.041).
- There was statistically significant difference in serum OPN level between smoker and non- smoker ICH patients (p-value=0.013).
- There was no statistically significant difference in serum OPN level between males and females (p- value=0.123).
- There was no statistically significant difference in serum OPN level in diabetic ICH patients when compared to non-diabetic ICH patients (p-value=0.421).
- There were no significant correlations between OPN level and any of the following; a) BMI (p-value= 0.451), b) laboratory parameters included: TGs (p-value= 0.204), cholesterol level (p-value= 0.343) and HDL ( p-value= 0.774) and RBS (p-value =0.680).