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游离DNA:急性缺血性中风患者静脉溶栓和/或机械取栓后神经功能结局的新型预测指标。

Cell free DNA: A Novel Predictor of Neurological Outcome after Intravenous Thrombolysis and/or Mechanical Thrombectomy in Acute Ischemic Stroke Patients.

作者信息

Vajpeyee Atulabh, Wijatmiko Teddy, Vajpeyee Manisha, Taywade Onjal

机构信息

Deparment of Neurology, Pacific Medical College & Hospital, Pacific Medical University, Udaipur, India.

Deparment of Biochemistry, Pacific Medical College & Hospital, Pacific Medical University, Udaipur, India.

出版信息

Neurointervention. 2018 Mar;13(1):13-19. doi: 10.5469/neuroint.2018.13.1.13. Epub 2018 Mar 2.

Abstract

PURPOSE

Several blood markers have been evaluated in stroke patients, but their role remains limited in clinical practice. This study was designed to evaluate the utility of cell free DNA (cf DNA) in stroke patients undergoing therapeutic intervention in the form of mechanical thrombectomy in acute ischemic stroke patients.

MATERIALS AND METHODS

Twenty-six patients with ischemic stroke who were managed with interventions like intravenous thrombolysis (IVT) and mechanical thrombectomy were recruited consecutively in this study. The cf DNA was extracted by using circulating nucleic acid kit and measured by real-time quantitative PCR assay for β-globin gene. The neurological outcome was measured by modified Rankin scale (mRS) score at three months after the onset of symptoms.

RESULTS

Cf DNA levels correlated with severity of stroke at the time of admission (r=0.421, P=0.032) and poor outcome at three months (r=0.606, P=0.001). Therapeutic intervention in the form of mechanical thrombectomy or IVT was associated with improved outcome in patients with cf DNA <10,000 kilogenome-equivalents/L (P=<0.05).

CONCLUSION

Cf DNA level correlated well with the 3 month outcome in acute ischemic stroke patients. It can be a potential supplementary marker to predict neurological outcome after therapeutic intervention.

摘要

目的

已经对中风患者的几种血液标志物进行了评估,但它们在临床实践中的作用仍然有限。本研究旨在评估游离DNA(cf DNA)在接受机械取栓治疗的急性缺血性中风患者中的效用。

材料与方法

本研究连续招募了26例接受静脉溶栓(IVT)和机械取栓等干预措施治疗的缺血性中风患者。使用循环核酸试剂盒提取cf DNA,并通过实时定量PCR检测β-珠蛋白基因进行测量。在症状发作后三个月通过改良Rankin量表(mRS)评分来衡量神经功能结局。

结果

cf DNA水平与入院时中风严重程度相关(r = 0.421,P = 0.032),与三个月时的不良结局相关(r = 0.606,P = 0.001)。对于cf DNA <10,000千基因组当量/L的患者,机械取栓或IVT形式的治疗干预与更好的结局相关(P <0.05)。

结论

cf DNA水平与急性缺血性中风患者三个月的结局密切相关。它可能是预测治疗干预后神经功能结局的潜在补充标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/870c/5847885/b7b31814e0cd/ni-13-13-g001.jpg

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