Serum Concentrations of Fibrinogen in Patients with Spinal Cord Injury and Its Relationship with Neurologic Function.

Abstract

Many studies have focused on axon regeneration after spinal cord injury (SCI), and fibrinogen has been reported to be an inhibitory factor for axon regeneration. However, most of these studies were based on animal experiments and invitro trials. Few studies reported serum concentrations of fibrinogen in patients with SCI. We sought to investigate the circulating serum concentrations of fibrinogen in patients with SCI and determine the relationship between fibrinogen concentrations and patients' neurologic function. A total of 306 patients who were diagnosed with acute SCI between January 2008 and March 2016 were included in this study. Patients with traumatic fractures of the extremities at the same period (220 of them with single fracture and 207 with multiple fractures) were enrolled as a control group. Additionally, 151 patients with no injury were involved as the normal group. The fibrinogen concentrations in each group were recorded and compared at different time points, and the correlation between fibrinogen serum concentrations and American Spinal Injury Association impairment scale in patients with SCI were analyzed. The mean serum concentrations of fibrinogen within 2 days after injury were 2.63 ± 0.76 g/L in the SCI group, 3.03 ± 0.82 g/L in the single-fracture group, and 2.86 ± 0.91 g/L in the multiple-fractures group, respectively, which were significant higher than those in the normal group (2.33 ± 0.43 g/L). Additionally, the concentrations of fibrinogen in SCI group were significantly lower compared with those in single- and multiple-fractures groups (P<0.001 and P= 0.001). The positive rate of fibrinogen concentrations was 12.42% in the SCI group, which was significantly lower than that of the single-fracture group (25.45%) and multiple-fractures group (25.13%) (P < 0.01). In patients with SCI, Spearman correlation analysis revealed that a significant correlation was found between fibrinogen serum concentrations and patients' American Spinal Injury Association impairment scales (r = 0.17, P<0.001). The serum concentrations of fibrinogen in patients with SCI were significantly increased after injury and were correlated with the severity of neurologic deficit in patients with SCI.