Gu Xiao-Lin, Liu Lin, Lu Xiang-Dong, Liu Zhen-Rui
Department of Neurology, The People's Hospital of Laiwu City, No. 1, Xuehudajie, Changshao North Road, Laiwu, 271100, Shandong Province, China.
Department of Neurosurgery, The People's Hospital of Laiwu City, Laiwu, 271100, Shandong Province, China.
Mol Neurobiol. 2016 Jul;53(5):2807-2814. doi: 10.1007/s12035-015-9151-0. Epub 2015 Apr 2.
Previous studies had shown that CXC chemokine ligand-12 (CXCL12) plays a significant role in animal models of ischemic stroke, but its role in human stroke is unclear. The aim of this study was to test the relationship between elevated serum circulating CXCL12 levels and the 1-year stroke recurrence in Chinese patients with acute ischemic stroke (AIS). All consecutive patients with first-ever acute ischemic stroke from January 2011 to September 2013 were recruited to participate in the study. Serum levels of CXCL12 and National Institute of Health Stroke Scale (NIHSS) were measured at the time of admission. Logistic regression analysis was used to evaluate the stroke recurrence according to serum CXCL12 levels. Receiver operating characteristic (ROC) curve was used to evaluate the accuracy of serum CXCL12 in predicting stroke recurrence. Clinical follow-up was performed at 1 year. In our study, 248 patients finished the 1-year follow-up. At 1-year follow-up, 31 patients had a recurrence ischemic stroke. The median CXCL12 levels were significantly higher in those who sustained a recurrence ischemic stroke compared with those who did not [24.2 ng/mL (IQR 15.4-33.7) vs 6.5 ng/mL (IQR 3.4-10.2); Z = 8.258, P < 0.0001]. In multivariate analysis, there was an increased risk of stroke recurrence associated with serum CXCL12 levels ≥12.15 ng/mL (OR 9.122, 95 % CI 6.103-15.104) after adjusting for above possible confounders. The time to recurrence stroke distribution between patients with baseline CXCL12 levels ≥12.15 ng/mL and those with baseline CXCL12 levels <12.15 ng/mL were significantly different (P < 0.0001, log-rank test). Elevated circulating CXCL12 levels at admission are strongly associated with the future recurrence of ischemic stroke in Chinese patients with AIS. Further studies are warranted to confirm this association and define the role for CXCL12 as a novel predictor biomarker for stroke recurrence.
以往研究表明，CXC趋化因子配体12（CXCL12）在缺血性中风动物模型中发挥重要作用，但其在人类中风中的作用尚不清楚。本研究旨在探讨中国急性缺血性中风（AIS）患者血清循环CXCL12水平升高与1年中风复发之间的关系。纳入2011年1月至2013年9月期间所有首次发生急性缺血性中风的连续患者参与本研究。入院时测定血清CXCL12水平和美国国立卫生研究院卒中量表（NIHSS）评分。采用逻辑回归分析根据血清CXCL12水平评估中风复发情况。采用受试者工作特征（ROC）曲线评估血清CXCL12预测中风复发的准确性。进行为期1年的临床随访。在我们的研究中，248例患者完成了1年随访。在1年随访时，31例患者发生缺血性中风复发。与未复发的患者相比，发生缺血性中风复发的患者CXCL12水平中位数显著更高[24.2 ng/mL（四分位间距15.4 - 33.7） vs 6.5 ng/mL（四分位间距3.4 - 10.2）；Z = 8.258，P < 0.0001]。在多变量分析中，在校正上述可能的混杂因素后，血清CXCL12水平≥12.15 ng/mL与中风复发风险增加相关（比值比9.122，95%可信区间6.103 - 15.104）。基线CXCL12水平≥12.15 ng/mL的患者与基线CXCL12水平<12.15 ng/mL的患者中风复发时间分布存在显著差异（P < 0.0001，对数秩检验）。中国AIS患者入院时循环CXCL12水平升高与未来缺血性中风复发密切相关。有必要进一步研究以证实这种关联，并确定CXCL12作为中风复发新的预测生物标志物的作用。
