Department of Neurology, First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Street, Dalian, 116011, People's Republic of China,
Neurol Sci. 2013 Sep;34(9):1591-5. doi: 10.1007/s10072-013-1291-2. Epub 2013 Jan 25.
Copeptin is a stable by-product of arginine-vasopressin synthesis and reflects its secretion. The objective of the study was to evaluate the predictive value of copeptine on functional outcome at 90-day follow-up from stroke onset. We conducted a prospective, observational cohort study in the emergency department of two hospitals and enrolled 125 patients with acute ischemic stroke. Plasma copeptin concentrations, determined by a CT-proAVP-luminescence-immunoassay, were measured. There was a good correlation between levels of plasma copeptin and NIHSS score (r = 0.733, P < 0.01). In the 41 patients (32.8 %) with a poor functional outcome, copeptin levels were higher compared with those in patients with a favorable outcome (27.3; IQR, 14.9-34.8 pmol/L vs. 12.9; IQR, 9.4-21.6 pmol/L; P < 0.0001). Copeptin levels in 18 patients who died were more than two times greater as compared to patients who survived (32.4; IQR, 18.7-38.5 pmol/L vs. 15.1; IQR, 12.4-24.6 pmol/L; P < 0.0001). After adjusting for all other significant outcome predictors, copeptin level remained an independent predictor for poor functional outcome and mortality with an odds ratio of 3.12 (95 % CI 1.54-6.46), 3.16 (95 % CI 0.92-6.15), respectively. Our study suggests that copeptin levels are a useful tool to predict outcome and mortality 3 months after acute ischemic stroke and have a potential to assist clinicians.
copeptin 是精氨酸加压素合成的稳定副产物,反映其分泌情况。本研究的目的是评估 copeptin 在中风发病后 90 天的功能结局预测价值。我们在两家医院的急诊部门进行了一项前瞻性观察队列研究,共纳入 125 例急性缺血性中风患者。通过 CT-proAVP-发光免疫测定法测定血浆 copeptin 浓度。血浆 copeptin 水平与 NIHSS 评分呈良好相关性(r = 0.733,P < 0.01)。在 41 例功能结局不良的患者(32.8%)中,copeptin 水平高于功能结局良好的患者(27.3;IQR,14.9-34.8 pmol/L 比 12.9;IQR,9.4-21.6 pmol/L;P < 0.0001)。18 例死亡患者的 copeptin 水平是存活患者的两倍以上(32.4;IQR,18.7-38.5 pmol/L 比 15.1;IQR,12.4-24.6 pmol/L;P < 0.0001)。在校正所有其他显著结局预测因素后,copeptin 水平仍然是功能结局不良和死亡率的独立预测因素,优势比分别为 3.12(95%CI 1.54-6.46)和 3.16(95%CI 0.92-6.15)。我们的研究表明,copeptin 水平是预测急性缺血性中风后 3 个月结局和死亡率的有用工具,具有辅助临床医生的潜力。