Purrucker Jan C, Herrmann Oliver, Lutsch Julia K, Zorn Markus, Schwaninger Markus, Bruckner Tom, Auffarth Gerd U, Veltkamp Roland
Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
Eur Neurol. 2014;72(5-6):278-84. doi: 10.1159/000363569. Epub 2014 Oct 16.
In patients presenting with acute vertigo or dizziness, identifying the posterior fossa stroke as the underlying cause can be a major challenge. We therefore evaluated the serum biomarkers for the differential diagnosis of nonvascular vertigo and posterior circulation stroke.
Of a total of 80 patients, 31 patients had an ischemic stroke in the posterior circulation and 12 infratentorial hemorrhage. Findings in these patients were compared with those in 22 patients with vertigo of nonvascular origin and 15 matched control patients without neurological symptoms. Blood samples drawn <24 h after symptom onset were analyzed for S100 calcium-binding protein B (S100β), matrix metalloproteinase 9 (MMP-9), soluble vascular cellular adhesion molecule-1 (sVCAM-1), and glial fibrillary acidic protein (GFAP).
RESULTS/CONCLUSION: Serum levels of S100β were significantly higher in stroke patients than in nonvascular vertigo patients. Serum concentrations of MMP-9 tended to be higher in stroke patients, whereas no significant differences among groups were found for sVCAM-1 and GFAP. Receiver-operating characteristic analysis revealed a sensitivity of 94.4% and a specificity of 31.8% for detecting stroke in patients presenting with vertigo for S100β. S100β may serve as a biomarker for distinguishing between vertigo of vascular causes and nonvascular, acute vertigo.
对于出现急性眩晕或头晕的患者,将后颅窝卒中识别为潜在病因可能是一项重大挑战。因此,我们评估了血清生物标志物在非血管性眩晕和后循环卒中鉴别诊断中的作用。
在总共80例患者中,31例患者发生后循环缺血性卒中,12例发生幕下出血。将这些患者的检查结果与22例非血管性眩晕患者及15例无神经症状的匹配对照患者的结果进行比较。对症状发作后<24小时采集的血样分析S100钙结合蛋白B(S100β)、基质金属蛋白酶9(MMP-9)、可溶性血管细胞黏附分子-1(sVCAM-1)和胶质纤维酸性蛋白(GFAP)。
结果/结论:卒中患者血清S100β水平显著高于非血管性眩晕患者。卒中患者血清MMP-9浓度往往较高,而sVCAM-1和GFAP在各组间未发现显著差异。受试者工作特征分析显示,对于以眩晕就诊的患者,S100β检测卒中的敏感性为94.4%,特异性为31.8%。S100β可作为区分血管性眩晕和非血管性急性眩晕的生物标志物。