Yang Xiao-Ying, Gao Shan, Ding Jie, Chen Yan, Zhou Xing-Sheng, Wang Jing-E
Department of Clinical Laboratory, Shanghai Jiao Tong University, Affiliated the Sixth People Hospital Fengxian Branch, Shanghai, P. R. China.
Department of Neurology, Shanghai Jiao Tong University, Affiliated the Sixth People Hospital Fengxian Branch, Shanghai, P. R. China.
PLoS One. 2014 Feb 24;9(2):e89756. doi: 10.1371/journal.pone.0089756. eCollection 2014.
Haemostatic biomarkers associated with poor outcome in acute ischemic stroke (AIS). The objective of the study was to evaluate the predictive value of plasma D-dimer (D-D) on functional outcome at 90-day follow-up from stroke onset.
We conducted a prospective, observational cohort study in the emergency department and enrolled 220 patients with AIS. Plasma D-D concentrations, determined by a particle-enhanced, immunoturbidimetric assay, were measured. Each patient's medical record was reviewed, and demographic, clinical, laboratory and neuroimaging information was abstracted.
There was a positive correlation between levels of D-D and the NIHSS (r = 0.361, p<0.001), and the infarct volume (r = 0.449, p<0.001). In the 69 patients with an unfavorable functional outcome, D-D levels were higher compared with those in patients with a favorable outcome [3.24(IQR, 2.18-4.60)mg/L vs 0.88(IQR, 0.35-1.77) mg/L; p<0.001]. After adjusting for all other significant outcome predictors, D-D level remained an independent predictor for unfavorable functional outcome and mortality with an odds ratio of 2.18 (95% CI, 1.55-2.83), 3.22 (95% CI, 2.05-6.43); respectively.
D-D levels are a useful tool to predict outcome and mortality 90-day after acute ischemic stroke and have a potential to assist clinicians.
寻找与急性缺血性卒中（AIS）预后不良相关的止血生物标志物。本研究的目的是评估卒中发作后90天随访时血浆D-二聚体（D-D）对功能预后的预测价值。
我们在急诊科进行了一项前瞻性观察队列研究，纳入了220例AIS患者。采用颗粒增强免疫比浊法测定血浆D-D浓度。查阅每位患者的病历，提取人口统计学、临床、实验室和神经影像学信息。
D-D水平与美国国立卫生研究院卒中量表（NIHSS）评分（r = 0.361，p<0.001）及梗死体积（r = 0.449，p<0.001）呈正相关。在69例功能预后不良的患者中，D-D水平高于预后良好的患者[3.24（四分位间距，2.18 - 4.60）mg/L vs 0.88（四分位间距，0.35 - 1.77）mg/L；p<0.001]。在对所有其他显著的预后预测因素进行校正后，D-D水平仍然是功能预后不良和死亡的独立预测因素，优势比分别为2.18（95%可信区间，1.55 - 2.83）、3.22（95%可信区间，2.05 - 6.43）。
D-D水平是预测急性缺血性卒中90天后预后和死亡的有用工具，有可能帮助临床医生。
