Chen X-L, Li Q, Huang W-S, Lin Y-S, Xue J, Wang B, Jin K-L, Shao B
Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
Department of Rehabilitation, Wenzhou people's hospital, Wenzhou, China.
Acta Neurol Scand. 2017 Aug;136(2):97-102. doi: 10.1111/ane.12688. Epub 2016 Sep 21.
Inflammation comprises important aspects of large-artery atherosclerosis (LAA) stroke pathophysiology. YKL-40 is a new and emerging biomarker that is associated with both acute and chronic inflammations. Elevated serum concentrations of YKL-40 have been reported in patients with atherosclerosis and other cardiovascular diseases. This study investigates whether serum YKL-40 concentrations on admission can predict 3-month clinical outcomes after LAA stroke.
We recruited control patients (n=85) and those with LAA stroke (n=141) according to the TOAST classification system. The modified Rankin scale at 3 months after stroke was used to evaluate the prognosis. The prognostic accuracy was assessed by the receiver operating characteristic curve.
Serum YKL-40 level was significantly higher for LAA patients than for controls (P<.001). Patients with poor outcomes (n=36) had significantly increased serum YKL-40 concentrations on admission (P=.01). High YKL-40 levels predicted poor functional outcome (OR=6.47, P=.02). Moreover, the combination of YKL-40 level and the NIHSS score could improve the prognostic accuracy of the NIHSS in predicting functional outcome (combined areas under the curve, 0.87; 95% CI, 0.80-0.94; P<.001).
The level of serum YKL-40 is a significant and independent biomarker to predict the clinical outcome of LAA stroke.
炎症是大动脉粥样硬化（LAA）性卒中病理生理学的重要方面。YKL-40是一种新出现的生物标志物，与急性和慢性炎症均相关。已有报道称，动脉粥样硬化和其他心血管疾病患者的血清YKL-40浓度升高。本研究旨在探讨LAA性卒中患者入院时的血清YKL-40浓度是否能够预测3个月后的临床结局。
我们根据TOAST分类系统招募了对照患者（n=85）和LAA性卒中患者（n=141）。采用卒中后3个月的改良Rankin量表评估预后。通过受试者工作特征曲线评估预后准确性。
LAA患者的血清YKL-40水平显著高于对照组（P<0.001）。预后不良的患者（n=36）入院时血清YKL-40浓度显著升高（P=0.01）。YKL-40水平高预示功能结局不良（OR=6.47，P=0.02）。此外，YKL-40水平与美国国立卫生研究院卒中量表（NIHSS）评分相结合可提高NIHSS预测功能结局的预后准确性（曲线下合并面积为0.87；95%CI，0.80-0.94；P<0.001）。
血清YKL-40水平是预测LAA性卒中临床结局的重要且独立的生物标志物。
