Emine Akinci, Keçiören Training and Research Hospital, Emergency Department, Ankara, Turkey.
Nurettin Özgür Doğan, Kocaeli University Medicine Faculty, Emergency Department, Kocaeli, Turkey.
Pak J Med Sci. 2014 May;30(3):606-10. doi: 10.12669/pjms.303.4456.
Serum gamma-glutamyl transferase (GGT) is a marker for alcohol consumption and hepatobiliary diseases. There are reports on the prognostic role of GGT in coronary artery diseases and stroke. The aim of our study was to identify the potential differences in GGT levels in different types of stroke, and to evaluate the correlation between GGT and 30-day mortality.
Patients diagnosed with stroke in emergency department between 01.01.2010 and 30.12.2012 was included in the study. Imaging techniques were used to distinguish between hemorrhagic and ischemic stroke. Ischemic strokes were further classified as either atherosclerotic/lacunar or embolic. Parameters including age, gender, vital signs (systolic and diastolic blood pressure), comorbid diseases (HT, DM, CAD, smoking and alcohol consumption), used medications, previous history of stroke, NIHSS score at the time of admission to emergency department, laboratory parameters (glucose, white blood cell count, hemoglobin, platelet, total cholesterol, creatinine) and duration of hospitalization were recorded. Death records were obtained from patients' medical records.
One thousand eighty six patients were included in the study. GGT levels were not significantly different between ischemic and hemorrhagic strokes (p=0.435). On the other hand, GGT levels in embolic strokes were significantly higher compared to atherosclerotic/lacunar strokes (p=0.001). GGT levels [median 24.50 (16.00-43.00)] in Intensive Care Unit patients were significantly higher compared to GGT level [22.00 (15.00-34.25)] in admitted to service beds patients (p=0.015). Median GGT level of deceased patients was 24.00 (16.00-41.25) and median GGT level of alive patients was 22.00 (15.00-35.00). GGT level of deceased patients was significantly higher compared to GGT levels of alive patients (p=0.048).
There was no difference in GGT levels between ischemic and hemorrhagic strokes; however, GGT levels in embolic strokes were significantly higher compared to atherosclerotic/lacunar strokes. High GGT levels are correlated with early mortality in stroke. We believe that GGT may be used as a predictor of mortality in future studies.
血清γ-谷氨酰转移酶（GGT）是酒精摄入和肝胆疾病的标志物。有报道称 GGT 在冠状动脉疾病和中风中具有预后作用。本研究的目的是确定不同类型中风中 GGT 水平的潜在差异，并评估 GGT 与 30 天死亡率之间的相关性。
纳入 2010 年 1 月 1 日至 2012 年 12 月 30 日期间在急诊科诊断为中风的患者。使用影像学技术区分出血性和缺血性中风。缺血性中风进一步分为动脉粥样硬化/腔隙性或栓塞性。记录参数包括年龄、性别、生命体征（收缩压和舒张压）、合并症（HT、DM、CAD、吸烟和饮酒）、使用的药物、既往中风史、急诊入院时 NIHSS 评分、实验室参数（血糖、白细胞计数、血红蛋白、血小板、总胆固醇、肌酐）和住院时间。从患者的病历中获取死亡记录。
本研究共纳入 1086 例患者。缺血性和出血性中风之间的 GGT 水平无显著差异（p=0.435）。另一方面，栓塞性中风的 GGT 水平明显高于动脉粥样硬化/腔隙性中风（p=0.001）。入住重症监护病房患者的 GGT 水平[中位数 24.50（16.00-43.00）]明显高于入住服务床位患者的 GGT 水平[22.00（15.00-34.25）]（p=0.015）。死亡患者的中位 GGT 水平为 24.00（16.00-41.25），存活患者的中位 GGT 水平为 22.00（15.00-35.00）。死亡患者的 GGT 水平明显高于存活患者（p=0.048）。
缺血性和出血性中风之间的 GGT 水平无差异；然而，栓塞性中风的 GGT 水平明显高于动脉粥样硬化/腔隙性中风。高 GGT 水平与中风早期死亡率相关。我们认为 GGT 可能在未来的研究中用作死亡率的预测指标。
