Hasırcı Buse, Okay Münevver, Ağırcan Dilek, Koçer Abdulkadir
Department of Neurology, Istanbul Medeniyet University Medical Faculty, 34720 Istanbul, Turkey.
Cardiovasc Psychiatry Neurol. 2013;2013:953672. doi: 10.1155/2013/953672. Epub 2013 Jun 13.
Background. Troponin increment is a highly sensitive and specific marker of myocardial necrosis. The reason of high troponin levels in acute stroke is not clear. The aim of this study was to identify the relationships between cardiac troponin-I (cTnI) level and stroke. Methods. This study recruited 868 patients who were admitted to Istanbul Medeniyet University due to acute ischemic stroke, and the diagnosis was confirmed by diffusion magnetic resonance imaging. The patients with the causes increasing troponin level were excluded from the study. A total of 239 patients were finally included in the study. Clinics were evaluated by the modified Rankin Scale (mRS) and the National Institutes of Health Stroke Scale (NIHSS). Results. Serum level of troponin was higher in ischemic stroke patients with anterior circulation involvement in comparison to posterior involvement or hemorrhagic stroke (P < 0.05). Higher troponin levels related to increased stroke scale scores at discharge in ischemic stroke (P < 0.05). The level of cTnI was correlated with stroke scale scores at both admission and discharge in posterior stroke patients (P < 0.01). Conclusion. cTnI is a highly specific and sensitive marker of myocardial damage, and its elevation was associated with more severe neurological deficits in acute ischemic stroke.
背景。肌钙蛋白升高是心肌坏死的一种高度敏感且特异的标志物。急性卒中时肌钙蛋白水平升高的原因尚不清楚。本研究的目的是确定心肌肌钙蛋白I（cTnI）水平与卒中之间的关系。方法。本研究纳入了868例因急性缺血性卒中入住伊斯坦布尔梅迪尼耶特大学的患者，诊断通过弥散磁共振成像得以证实。将肌钙蛋白水平升高原因的患者排除在研究之外。最终共有239例患者纳入研究。采用改良Rankin量表（mRS）和美国国立卫生研究院卒中量表（NIHSS）对临床情况进行评估。结果。与后循环受累或出血性卒中相比，前循环受累的缺血性卒中患者血清肌钙蛋白水平更高（P < 0.05）。更高的肌钙蛋白水平与缺血性卒中出院时卒中量表评分增加相关（P < 0.05）。后循环卒中患者入院和出院时cTnI水平均与卒中量表评分相关（P < 0.01）。结论。cTnI是心肌损伤的一种高度特异且敏感的标志物，其升高与急性缺血性卒中更严重的神经功能缺损相关。
