Cheng Xuan, Lian Ya-Jun, Ma Yun-Qing, Xie Nan-Chang, Wu Chuan-Jie
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi Area, Zhengzhou, 450000, Henan Province, China.
Mol Neurobiol. 2017 Mar;54(2):895-903. doi: 10.1007/s12035-015-9645-9. Epub 2016 Jan 16.
The aim of this study was to examine whether the circulating CXC chemokine ligand-12 (CXCL12) level can predict a 6-month outcome in Chinese patients with acute ischemic stroke (AIS). In a prospective study, CXCL12 levels were measured on admission in the serum of 304 consecutive patients with AIS. The prognostic value of CXCL12 to predict the functional outcome and mortality within 1 year was compared with the National Institutes of Health Stroke Scale score and with other known outcome predictors. A receiver operating characteristic (ROC) curve was used to evaluate the accuracy of serum CXCL12 in predicting functional outcome and mortality. Patients with an unfavorable outcome and non-survivors had significantly increased CXCL12 levels on admission (P < 0.0001 and P < 0.0001). Multivariate logistic regression analysis adjusted for common risk factors showed that CXCL12 (≥12.4 ng/mL; third quartile) was an independent predictor of functional outcome (odds ratio [OR] = 8.81; 95 % confidence interval [CI] 4.92-24.79) and mortality (OR = 10.15; 95 %CI 2.44-27.98). The area under the receiver operating characteristic curve of CXCL12 was 0.84 (95 % CI 0.76-0.92) for functional outcome and 0.87 (95 % CI 0.80-0.93) for mortality. Circulating CXCL12 serum levels at admission is a useful and complementary biomarker to predict functional outcome and mortality 6 months after acute ischemic stroke.
本研究旨在探讨循环CXC趋化因子配体12（CXCL12）水平能否预测中国急性缺血性卒中（AIS）患者的6个月预后。在一项前瞻性研究中，对304例连续的AIS患者入院时血清中的CXCL12水平进行了检测。将CXCL12预测1年内功能预后和死亡率的预后价值与美国国立卫生研究院卒中量表评分及其他已知的预后预测指标进行了比较。采用受试者工作特征（ROC）曲线评估血清CXCL12预测功能预后和死亡率的准确性。预后不良的患者和非幸存者入院时CXCL12水平显著升高（P＜0.0001和P＜0.0001）。经常见风险因素校正的多因素logistic回归分析显示，CXCL12（≥12.4 ng/mL；第三四分位数）是功能预后（比值比[OR] = 8.81；95%置信区间[CI] 4.92 - 24.79）和死亡率（OR = 10.15；95%CI 2.44 - 27.98）的独立预测指标。CXCL12的受试者工作特征曲线下面积对于功能预后为0.84（95%CI 0.76 - 0.92），对于死亡率为0.87（95%CI 0.80 - 0.93）。入院时循环CXCL12血清水平是预测急性缺血性卒中后6个月功能预后和死亡率的一种有用且互补的生物标志物。
