Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
Division of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, 15282, USA.
Sci Rep. 2018 Jan 17;8(1):993. doi: 10.1038/s41598-018-19267-4.
The objective of this study is to explore whether procalcitonin (PCT) can serve as an early biomarker of malignant cerebral edema in patients with massive cerebral infarction (MCI). Ninety-three patients with acute MCI were divided into death or survival groups based on whether they died or survived within 1 week of cerebral herniation. Differences in laboratory parameters between these two groups were analyzed by univariate analysis, followed by multivariate logistic regression analyses if the influencing factors were significantly different. Compared with the survival group, the patients in the death group had a larger cerebral infarct area, higher body temperature, neutrophil counts, PCT level, and neuron-specific enolase (NSE) level within 48 h of onset. Multivariate logistic regression analyses revealed an odds ratio (OR) of 1.830 or 1.235 for PCT and neutrophil counts respectively, suggesting that PCT and neutrophil counts are two independent risk factors for death in MCI. The area under receiver operating characteristic (ROC) curve was 0.754 for PCT, larger than that for neutrophil counts. Thus, both serum PCT levels and neutrophil counts can be used as biomarkers to predict malignant cerebral edema at the early stages after MCI, but PCT levels are superior predictors of malignant cerebral edema.
本研究旨在探讨降钙素原 (PCT) 是否可作为大面积脑梗死 (MCAI) 患者恶性脑水肿的早期生物标志物。根据是否在脑疝发生后 1 周内死亡，将 93 例急性 MCAI 患者分为死亡组和存活组。通过单因素分析比较两组实验室参数的差异，如果影响因素有显著差异，则进行多因素逻辑回归分析。与存活组相比，死亡组患者的脑梗死面积更大，发病后 48 h 内体温、中性粒细胞计数、PCT 水平和神经元特异性烯醇化酶 (NSE) 水平更高。多因素逻辑回归分析显示 PCT 和中性粒细胞计数的优势比 (OR) 分别为 1.830 和 1.235，提示 PCT 和中性粒细胞计数是 MCAI 患者死亡的两个独立危险因素。PCT 的受试者工作特征 (ROC) 曲线下面积为 0.754，大于中性粒细胞计数。因此，血清 PCT 水平和中性粒细胞计数均可作为预测 MCAI 后早期恶性脑水肿的生物标志物，但 PCT 水平是恶性脑水肿的更好预测指标。
