血浆骨保护素与急性缺血性脑卒中患者的卒中严重程度和微栓子信号的发生相关。
Plasma Osteoprotegerin Correlates with Stroke Severity and the Occurrence of Microembolic Signals in Patients with Acute Ischemic Stroke.
机构信息
Beijing Institute of Brain Disorders, Capital Medical University, Beijing 100069, China.
Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100069, China.
出版信息
Dis Markers. 2019 May 2;2019:3090364. doi: 10.1155/2019/3090364. eCollection 2019.
BACKGROUND
Instability of atherosclerotic plaques is associated with the occurrence of stroke. Microembolic signals (MESs) are an indicator of unstable plaque. A relationship between plasma osteoprotegerin (OPG) and ischemic stroke has already been identified. The aim of this study was to investigate whether plasma OPG levels have a relationship with MESs and to evaluate the feasibility of OPG as a biomarker of stroke severity and occurrence of MESs.
METHODS
Our study consisted of 127 patients with large artery atherosclerosis stroke and 56 controls. Patients were classified into subgroups based on stroke severity and the occurrence of MESs. MES-monitoring was performed for 60 min using transcranial Doppler within 72 h of stroke onset. Stroke severity at admission was assessed by the National Institutes of Health Stroke Scale.
RESULTS
Plasma OPG levels were significantly associated with stroke, MESs, and stroke severity at admission (adjusted OR [95% CI]: 1.002 [1.001-1.003] < 0.001; 1.002 [1.001-1.003] = 0.001; 1.001 [1.000-1.002] = 0.028). When plasma OPG levels were used to determine the stroke severity, the area under the receiver-operating characteristic curve (AUC) was 0.734 (95% CI: 0.625-0.843) based on a cutoff value of 1998.44 pg/ml; the sensitivity and specificity of this test were 80.6% and 65.6%, respectively. Furthermore, when the levels of OPG were used to distinguish the presence of MESs, the AUC was 0.766 (95% CI: 0.672-0.860); the cutoff value was 2107.91 pg/ml. The sensitivity of this cutoff value was 68.8% and the specificity was 73.7%.
CONCLUSIONS
Plasma OPG levels correlate with stroke severity and the occurrence of MESs.
背景
动脉粥样硬化斑块的不稳定性与中风的发生有关。微栓子信号（MESs）是不稳定斑块的一个指标。已经确定了血浆骨保护素（OPG）与缺血性中风之间的关系。本研究的目的是探讨血浆 OPG 水平是否与 MESs 有关，并评估 OPG 是否可作为中风严重程度和 MESs 发生的生物标志物。
方法
我们的研究包括 127 名大动脉粥样硬化性中风患者和 56 名对照者。根据中风严重程度和 MESs 的发生情况，将患者分为亚组。在中风发病后 72 小时内，使用经颅多普勒进行 60 分钟的 MES 监测。入院时的中风严重程度采用国立卫生研究院中风量表进行评估。
结果
血浆 OPG 水平与中风、MESs 和入院时的中风严重程度显著相关（调整后的 OR [95%CI]：1.002 [1.001-1.003] < 0.001；1.002 [1.001-1.003] = 0.001；1.001 [1.000-1.002] = 0.028）。当使用血浆 OPG 水平来确定中风严重程度时，根据截断值为 1998.44 pg/ml，受试者工作特征曲线下面积（AUC）为 0.734（95%CI：0.625-0.843）；该检验的敏感性和特异性分别为 80.6%和 65.6%。此外，当使用 OPG 水平来区分 MESs 的存在时，AUC 为 0.766（95%CI：0.672-0.860）；截断值为 2107.91 pg/ml。该截断值的敏感性为 68.8%，特异性为 73.7%。
结论
血浆 OPG 水平与中风严重程度和 MESs 的发生相关。
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