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入院时血浆内脂素水平与急性自发性基底节出血患者的血肿增大和早期神经功能恶化密切相关。

Admission plasma visfatin level strongly correlates with hematoma growth and early neurologic deterioration in patients with acute spontaneous basal ganglia hemorrhage.

机构信息

Department of Neurosurgery, The first people's Hospital of Xiaoshan District of Hangzhou City, 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, China.

出版信息

Clin Chim Acta. 2013 Oct 21;425:85-9. doi: 10.1016/j.cca.2013.07.025. Epub 2013 Jul 31.

Abstract

BACKGROUND

Visfatin, a proinflammatory mediator, has been associated with poor clinical outcomes after acute brain injury. The present study is designed to investigate the potential association between plasma visfatin levels and the risk of hematoma growth (HG) and early neurologic deterioration (END) after intracerebral hemorrhage.

METHODS

There were 85 patients as cases who presented with first-time hemorrhagic stroke that were assessed within 6h after the incident. The control group consisted of 85 healthy volunteers. HG was defined as hematoma enlargement >33% at 24h. END was defined as an increase of ≥ 4 points in National Institute of Health Stroke Scale score at 24h from symptoms onset. Plasma visfatin levels were determined using enzyme immunoassay.

RESULTS

Plasma visfatin levels were significantly higher in patients compared to controls. Plasma visfatin level emerged as an independent predictor of HG [odds ratio (OR), 1.154; 95% confidence interval (CI), 1.046-3.108; P=0.009] and END (OR, 1.195; 95% CI, 1.073-3.516; P=0.005). For predicting HG, area under curve (AUC) of plasma visfatin level (0.814; 95% CI: 0.715-0.890) was similar to that of hematoma volume (0.839; 95% CI, 0.743-0.909) (P=0.703). For predicting END, AUC of plasma visfatin level (0.828; 95% CI: 0.730-0.901) was similar to that of hematoma volume (0.863; 95% CI, 0.771-0.928) (P=0.605). Visfatin did not improve AUC of hematoma volume for predicting HG and END (both P>0.05).

CONCLUSION

Plasma visfatin level represents a novel biomarker for predicting HG and END.

摘要

背景

内脏脂肪素是一种促炎介质,与急性脑损伤后的不良临床结局有关。本研究旨在探讨血浆内脏脂肪素水平与脑出血后血肿增大(HG)和早期神经功能恶化(END)风险的潜在关系。

方法

共有 85 例首次发生脑出血的患者作为病例,在发病后 6 小时内进行评估。对照组由 85 名健康志愿者组成。HG 定义为 24 小时血肿扩大>33%。END 定义为发病后 24 小时内 NIHSS 评分增加≥4 分。使用酶联免疫吸附法测定血浆内脏脂肪素水平。

结果

与对照组相比,患者的血浆内脏脂肪素水平明显升高。血浆内脏脂肪素水平是 HG 的独立预测因子[比值比(OR),1.154;95%置信区间(CI),1.046-3.108;P=0.009]和 END(OR,1.195;95%CI,1.073-3.516;P=0.005)。对于预测 HG,血浆内脏脂肪素水平的曲线下面积(AUC)(0.814;95%CI:0.715-0.890)与血肿体积的 AUC(0.839;95%CI,0.743-0.909)相似(P=0.703)。对于预测 END,血浆内脏脂肪素水平的 AUC(0.828;95%CI:0.730-0.901)与血肿体积的 AUC(0.863;95%CI,0.771-0.928)相似(P=0.605)。内脏脂肪素并不能提高血肿体积预测 HG 和 END 的 AUC(均 P>0.05)。

结论

血浆内脏脂肪素水平是预测 HG 和 END 的一种新的生物标志物。

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