Sienkiewicz-Jarosz Halina, Gałecka-Wolska Maria, Bidziński Andrzej, Turzyńska Danuta, Sobolewska Alicja, Lipska Beata, Płaźnik Adam, Ryglewicz Danuta
I Klinika Neurologiczna, Instytut Psychiatrii i Neurologii, ul. J. Sobieskiego 9, 02-957 Warszawa.
Neurol Neurochir Pol. 2009 Mar-Apr;43(2):126-33.
Previous studies suggested that biochemical markers of brain damage could act as prognostic factors in ischaemic stroke. The aim of the present study was to assess predictive value of the selected biomarkers S100B protein, neuron-specific enolase (NSE), C-reactive protein (CRP) and D-dimers, as well as GABA and excitatory amino-acids (EAA) measured in blood for 3-month functional outcome in ischaemic stroke patients.
We investigated 54 patients with ischaemic stroke (mean age: 73.3 +/-11.7). Serum concentrations of S100B, NSE, CRP, EAA and GABA, as well as plasma concentrations of D-dimers, were assessed in blood samples taken at admission and at 12, 24, and 72 hours after stroke onset. Functional status was measured with modified Rankin Scale (mRS) 3 months after stroke onset.
Significant independent predictors of outcome in ischaemic stroke patients 3 months after stroke were: S100B level at 12 h (OR: 1.7; 95% CI: 0.5-7.0; p = 0.007), NSE at 12 h (OR: 2.4; 95% CI: 0.7-8.1; p = 0.037), 24 h (OR: 10.2; 95% CI: 2.4-43.2; p = 0.0007), and 72 h (OR: 10.2; 95% CI: 2.3-45.0; p = 0.0001), CRP at 72 h (OR: 8.3; 95% CI: 1.5-45.4; p = 0.009) and D-dimers at admission (OR: 4.8; 95% CI: 1.1-20.7; p = 0.02), 24 h (OR: 5.5; 95% CI: 1.4-20.9; p = 0.004), and 72 h after stroke onset (OR: 2.7; 95% CI: 0.6-11.8; p = 0.01).
The results of the present study are consistent with previous evidence indicating that selected biomarkers could help in prediction of the outcome in ischaemic stroke early after symptoms onset.
先前的研究表明，脑损伤的生化标志物可作为缺血性卒中的预后因素。本研究的目的是评估所选生物标志物S100B蛋白、神经元特异性烯醇化酶（NSE）、C反应蛋白（CRP）和D-二聚体，以及血液中检测到的γ-氨基丁酸（GABA）和兴奋性氨基酸（EAA）对缺血性卒中患者3个月功能结局的预测价值。
我们调查了54例缺血性卒中患者（平均年龄：73.3±11.7岁）。在入院时以及卒中发作后12、24和72小时采集的血样中评估S100B、NSE、CRP、EAA和GABA的血清浓度，以及D-二聚体的血浆浓度。在卒中发作3个月后用改良Rankin量表（mRS）测量功能状态。
缺血性卒中患者卒中后3个月结局的显著独立预测因素为：卒中后12小时的S100B水平（OR：1.7；95%CI：0.5 - 7.0；p = 0.007）、12小时的NSE（OR：2.4；95%CI：0.7 - 8.1；p = 0.037）、24小时（OR：10.2；95%CI：2.4 - 43.2；p = 0.0007）和72小时（OR：10.2；95%CI：2.3 - 45.0；p = 0.0001）、72小时的CRP（OR：8.3；95%CI：1.5 - 45.4；p = 0.009）以及入院时的D-二聚体（OR：4.8；95%CI：1.1 - 20.7；p = 0.02）、24小时（OR：5.5；95%CI：1.4 - 20.9；p = 0.004）和卒中发作后72小时（OR：2.7；95%CI：0.6 - 11.8；p = 0.01）。
本研究结果与先前的证据一致，表明所选生物标志物有助于在症状发作后早期预测缺血性卒中的结局。
