Abstract: Abstract：Objective To investigate the changes of serum levels of Nesfatin-1 and matrix metalloproteinase-9 (MMP-9) in patients with aneurysmal subarachnoid hemorrhage (aSAH) and their relationship with prognosis. Methods A total of 165 patients with aSAH were selected as the case group. According to the 90-day mortality in the case group, they were divided into survival group (n=129) and death group (n=36). The levels of Nesfatin-1 and MMP-9 were measured and clinical data were collected. The clinical values of Nesfatin-1 and MMP-9 in the prognosis of aSAH patients were evaluated by ROC and AUC. Kaplan-Merier method was used to draw survival curve of aSAH patients, and the risk factors of death in aSAH patients were analyzed by multivariate Logistic regression. Results The serum levels of Nesfatin-1 and MMP-9 were significantly higher in death group than those of survival group (P＜0.05). The AUC curve areas of serum levels of Nesfatin- 1 and MMP-9 for predicting the prognosis of aSAH patients were 0.859 (95%CI：0.796-0.908) and 0.801 (95%CI：0.731- 0.859). When the critical values were 9.98 μg / L and 402.21 μg / L, the sensitivities were 0.889 and 0.833, and the specificities were 0.651 and 0.752 respectively. The Kaplan-Meier survival curve analysis showed that the 90-day cumulative survival rate was significantly lower in aSAH patients with Nesfatin-1≥9.98 μg/L and MMP-9≥402.21 μg/L than that of patients with Nesfatin-1＜9.98 μg / L and MMP-9＜402.21 μg / L (P＜0.001). Logistics regression analysis showed that Nesfatin-1≥9.98 μg/L (OR=2.167，95%CI：1.776-2.642), MMP-9≥402.21 μg/L (OR=1.124，95%CI：1.029- 1.227), Hunt-Hess grade Ⅳ-Ⅴ (OR=2.246，95%CI：1.676-3.010) and Fisher grade 3-4 (OR=2.760，95%CI：1.369-5.565) were risk factors for predicting mortality in patients with aSAH. Conclusion Serum levels of Nesfatin-1 and MMP-9 are closely related to the prognosis of aSAH, and could be used as an evaluation index to predict the prognosis of patients with aSAH.

Key words: aneurysmal, subarachnoid hemorrhage, ingestion inhibitor-1, matrix metalloproteinase-9, prognosis