Xue Lixia, Chen Hao, Lu Kaili, Huang Jiankang, Duan Hao, Zhao Yuwu
Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Department of Neurosurgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
J Neurol Sci. 2017 Apr 15;375:52-57. doi: 10.1016/j.jns.2017.01.039. Epub 2017 Jan 12.
Neuroglobin (NGB) has been described as a neuroprotective agent in cerebral ischemia, hypoxia inducible factor (HIF) has shown an important role in modulating hypoxic and ischemic injury, and therefore they have the potential to impact outcomes after acute ischemic stroke (AIS). Thus, we investigated early changes in the concentrations of serum NGB and HIF-1α after AIS and evaluated the relations of both NGB and HIF-1α to stroke severity and prognosis.
We prospectively measured the serum concentrations of NGB and HIF-1α in 40 patients with AIS at 24, 48, 72, and 96h after stroke. Correlation combined with infarct size and National Institutes of Health Stroke Scale (NIHSS) score of the patients was analyzed. Receiver operating characteristic (ROC) curve was used to appraise their value in predicting the 90-day outcome after AIS.
Serum NGB concentrations increased and peaked at 72h after AIS, whereas serum concentrations of HIF-1α increased for 48h. Peak serum NGB concentration correlated significantly with both infarct size (R=0.484, p<0.001) and admission NIHSS score (R=0.578, p<0.001), while serum HIF-1α concentration was only correlated to a patient's infarct size (R=0.394, p<0.001). ROC curve analysis suggested that the serum NGB concentration had a significantly better predictive power for poor outcome.
NGB level increased in serum after AIS accompanied by increases in serum HIF-1α, and was suggested as a predictor of stroke severity and poor prognosis.
神经球蛋白(NGB)被认为是脑缺血中的一种神经保护剂,缺氧诱导因子(HIF)在调节缺氧和缺血性损伤中发挥了重要作用,因此它们有可能影响急性缺血性卒中(AIS)后的预后。因此,我们研究了AIS后血清NGB和HIF-1α浓度的早期变化,并评估了NGB和HIF-1α与卒中严重程度及预后的关系。
我们前瞻性地测定了40例AIS患者在卒中后24、48、72和96小时的血清NGB和HIF-1α浓度。分析了其与患者梗死灶大小及美国国立卫生研究院卒中量表(NIHSS)评分的相关性。采用受试者工作特征(ROC)曲线评估它们在预测AIS后90天预后中的价值。
AIS后血清NGB浓度升高并在72小时达到峰值,而血清HIF-1α浓度在48小时内升高。血清NGB峰值浓度与梗死灶大小(R=0.484,p<0.001)和入院时NIHSS评分(R=0.578,p<0.001)均显著相关,而血清HIF-1α浓度仅与患者梗死灶大小相关(R=0.394,p<0.001)。ROC曲线分析表明,血清NGB浓度对不良预后具有显著更好的预测能力。
AIS后血清NGB水平升高,同时血清HIF-1α升高,提示其可作为卒中严重程度和不良预后的预测指标。