Zhang Chenhuan, Huang Ping, Zhang Peipei, Zhou Mo, Gao Ya, Zhang Yonghong, Guo Yumei, Lv Liying, Xu Tan
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China.
Medical Records Room, Changzhou Traditional Chinese Medicine Hospital, Changzhou, Jiangsu, China.
Curr Neurovasc Res. 2018;15(4):305-311. doi: 10.2174/1567202616666181123150917.
There was a lack of studies on the association between Human Cytomegalovirus (HCMV) infection and prognosis of ischemic stroke, although it was indicated that human cytomegalovirus DNA has played a role in several cardiovascular disorders.
To examine the association between HCMV IgM levels in the acute phase and death and major disability after 2 weeks of acute ischemic stroke.
Serum HCMV IgM levels were measured in 1150 participants in China. Study outcome data on major disability and combined outcome of death and major disability were collected at 2 weeks after stroke onset or hospital discharge.
After 2 weeks of follow-up, 351 participants (30.52%) suffered from a major disability or died. Serum HCMV IgM was correlated with the combined outcome of death and major disability significantly after adjustment confounding factors. For example, the highest quartile of HCMV IgM was related to an odds ratio (95% confidence interval) of 1.84 (1.12-3.11) for the combined outcome. Risk prediction of the combined outcome was improved by the addition of serum HCMV IgM to conventional risk factors (net reclassification index 25.41%, p＝0.0002; integrated discrimination improvement 0.70%, p＝0.04377).
Elevated serum HCMV IgM levels in the acute phase of ischemic stroke were correlated with increased risk of combined outcome of death and major disability, indicating that serum HCMV IgM could be an important predictive factor for poor prognosis of ischemic stroke.
尽管有研究表明人巨细胞病毒DNA在多种心血管疾病中发挥作用，但关于人巨细胞病毒（HCMV）感染与缺血性中风预后之间关联的研究尚少。
探讨急性缺血性中风急性期HCMV IgM水平与2周后死亡及严重残疾之间的关联。
对中国1150名参与者的血清HCMV IgM水平进行检测。在中风发作后2周或出院时收集严重残疾以及死亡和严重残疾综合结局的研究结果数据。
随访2周后，351名参与者（30.52%）出现严重残疾或死亡。在调整混杂因素后，血清HCMV IgM与死亡和严重残疾的综合结局显著相关。例如，HCMV IgM最高四分位数与综合结局的比值比（95%置信区间）为1.84（1.12 - 3.11）。将血清HCMV IgM添加到传统危险因素中可改善综合结局的风险预测（净重新分类指数25.41%，p＝0.0002；综合判别改善0.70%，p＝0.04377）。
缺血性中风急性期血清HCMV IgM水平升高与死亡和严重残疾综合结局风险增加相关，表明血清HCMV IgM可能是缺血性中风预后不良的重要预测因素。
