Department of Neurology-Stroke Unit, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, University of Santiago de Compostela, Spain.
Clin Sci (Lond). 2011 Jul;121(1):11-7. doi: 10.1042/CS20100427.
Ischaemic stroke is associated with an excessive release of glutamate in brain. GOT (glutamate-oxaloacetate transaminase) and GPT (glutamate-pyruvate transaminase) are two enzymes that are able to metabolize blood glutamate facilitating the lowering of extracellular levels of brain glutamate. Our aim was to study the association between blood levels of both enzymes and stroke outcome in patients with acute ischaemic stroke. We prospectively studied 365 patients with first ischaemic stroke<12 h. Glutamate, GOT and GPT levels were determined in blood samples obtained at admission. We considered functional outcome at 3 months [good outcome: mRS (modified Rankin Scale)≤2; poor outcome mRS >2], END (early neurological deterioration) in the first 72 h [increment ≥4 points in NIHSS (National Institutes of Health Stroke Scale)] and infarct volume [CT (computed tomography) at 36-72 h] as end points. We have found an inverse correlation between GOT and GPT levels and blood glutamate levels. Patients with poor outcome showed lower levels of GOT (11.9±8.2 compared with 22.7±10.2 m-units/ml, P<0.0001) and GPT (19.5±14.3 compared with 24.7±20.3 m-units/ml; P=0.004). A negative correlation has been found between GOT (Pearson coefficient=-0.477, P<0.0001) and GPT (Pearson coefficient=-0.116; P=0.027) levels and infarct volume. Patients with END showed higher levels of blood glutamate (381.7±97.9 compared with 237.6±114.0 μmol/l, P<0.0001) and lower levels of GOT (10.8±6.7 compared with 18.1±10.8 m-units/ml; P<0.0001). This clinical study shows an association between high blood GOT and GPT levels and good outcome in ischaemic stroke patients, this association being stronger for GOT than GPT levels.
缺血性中风与大脑中谷氨酸的过度释放有关。GOT（谷氨酸-草酰乙酸转氨酶）和 GPT（谷氨酸-丙酮酸转氨酶）是两种能够代谢血液中谷氨酸的酶，有助于降低大脑谷氨酸的细胞外水平。我们的目的是研究急性缺血性中风患者血液中两种酶的水平与中风结局之间的关系。我们前瞻性研究了 365 例 12 小时内首次发生的缺血性中风患者。在入院时采集的血液样本中测定谷氨酸、GOT 和 GPT 水平。我们将 3 个月时的功能结局[良好结局：mRS（改良 Rankin 量表）≤2；不良结局 mRS>2]、72 小时内的早期神经功能恶化（END）[NIHSS（美国国立卫生研究院中风量表）增加≥4 分]和梗塞体积[36-72 小时的 CT（计算机断层扫描）]作为终点。我们发现 GOT 和 GPT 水平与血液谷氨酸水平呈负相关。不良结局患者 GOT（11.9±8.2 与 22.7±10.2 m-units/ml，P<0.0001）和 GPT（19.5±14.3 与 24.7±20.3 m-units/ml，P<0.0001）水平较低。GOT（Pearson 系数=-0.477，P<0.0001）和 GPT（Pearson 系数=-0.116；P=0.027）水平与梗塞体积呈负相关。END 患者血液谷氨酸水平较高（381.7±97.9 与 237.6±114.0 μmol/l，P<0.0001），GOT 水平较低（10.8±6.7 与 18.1±10.8 m-units/ml，P<0.0001）。这项临床研究表明，缺血性中风患者血液中 GOT 和 GPT 水平与良好结局之间存在关联，GOT 水平与结局的关联强于 GPT 水平。
