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基于生物标志物的诊断测试在出血性-缺血性中风鉴别诊断中的价值。

Value of biomarker-based diagnostic test in differential diagnosis of hemorrhagic-ischemic stroke.

作者信息

Kavalci C, Genchallac H, Durukan P, Cevik Y

机构信息

Trakya University Faculty of Medicine, Emergency Department, Edirne, Turkey.

出版信息

Bratisl Lek Listy. 2011;112(7):398-401.

Abstract

BACKGROUND AND AIM

Stroke is an emergency which threatens life and the third leading cause of death in developed countries and the leading cause of long-term disability. By means of this study, it was aimed to evaluate the position of triage stroke panel in differential diagnosis of acute hemorrhagic stroke and ischemic stroke and sub-types of ischemic stroke.

MATERIAL AND METHODS

Patients with acute stroke admitted to Emergency Department were prospectively recruited between June 2008-January 2009. BNP, D-dimer, MMP-9, S-100b levels were asseyed. Statistical significance for intergroup differences was assessed by Pearson's chi2 for categorical variables and Mann-Whitney U test or Kruskal-Wallis test for continuous variables.

RESULTS AND CONCLUSION

A total of 100 consecutive patients with a diagnosis of stroke were evaluated. Of these, 29 (29%) patients had brain hemorrhages on the computed tomography scan performed the Emergency Department, 71 (71%) patients had ischemic stroke. It was observed that the intercept obtained as a result of jointly evaluating BNP, D-dimer, MMP9 and S100b is more important in differential diagnosis (p < 0.005). We suggest that using a combination of plasma biomarkers may be usefull to ischemic or hemorrhagic stroke for differential diagnosis (Tab. 4, Ref. 22).

摘要

背景与目的

中风是一种危及生命的急症,在发达国家是第三大死因,也是长期残疾的主要原因。通过本研究,旨在评估分诊中风小组在急性出血性中风、缺血性中风以及缺血性中风亚型鉴别诊断中的作用。

材料与方法

前瞻性纳入2008年6月至2009年1月期间入住急诊科的急性中风患者。检测脑钠肽(BNP)、D-二聚体、基质金属蛋白酶-9(MMP-9)、S-100b水平。分类变量组间差异的统计学显著性采用Pearson卡方检验评估,连续变量采用Mann-Whitney U检验或Kruskal-Wallis检验评估。

结果与结论

共评估了100例连续诊断为中风的患者。其中,29例(29%)患者在急诊科进行的计算机断层扫描显示有脑出血,71例(71%)患者为缺血性中风。观察发现,联合评估BNP、D-二聚体、MMP9和S100b所得到的截距在鉴别诊断中更为重要(p<0.005)。我们建议,联合使用血浆生物标志物可能有助于缺血性或出血性中风的鉴别诊断(表4,参考文献22)。

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