Hu Fu-Yong, Wu Juncang, Tang Qiqiang, Zhang Ji, Chen Zhengxu, Wang Xiaoqiang, Liu Qiuwan, Wang Juan, Ge Wei, Qun Sen
Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
School of Public Health, Bengbu Medical College, Bengbu, China.
Front Neurol. 2020 Jan 9;10:1334. doi: 10.3389/fneur.2019.01334. eCollection 2019.
Inflammation plays a significant role in the pathogenesis of acute ischemic stroke (AIS). The role of β2-microglobulin (β2M) as a potential initiator of the inflammatory response in AIS is unclear. The purpose of this study was to analyze the relationship of serum β2M with the recurrence risk and 3-month outcome of AIS. A total of 205 patients with AIS were recruited, and their clinical and biochemical characteristics were collected. All patients were followed up for 3 months after stroke onset, and the occurrence of death or major disability at 3 months after onset was the outcome of interest in this study. We evaluated the association of serum β2M levels with the National Institute of Health Stroke Scale (NIHSS) scores, modified Rankin Scale (mRS) scores, and Essen Stroke Risk Score (ESRS) values in patients with AIS. Then, we used receiver operating curve analysis to calculate the optimal cutoff value for discriminating outcomes in patients with AIS and a binary logistic regression model to evaluate the risk factors for a poor outcome after AIS. Our results showed that serum β2M levels were significantly and positively correlated with ESRS values ( = 0.176, < 0.001) and mRS scores ( = 0.402, < 0.001), but the levels of β2M were not correlated with NIHSS scores ( = 0.080, = 0.255) or with infarct volume ( = 0.013, = 0.859). In a further study, we found that 121 patients (59.02%) had poor outcomes. The optimal β2M cutoff to predict the 3-month outcome of AIS in this study was 1.865 mg/l, and β2M was independently associated with a poor outcome at 3 months ( = 3.325, 95% confidence interval: 1.089~10.148). In conclusion, we inferred that serum β2M was positively associated with the recurrence risk and 3-month outcome of AIS, but it did not appear to be directly related to the severity of AIS or the size of the infarct at admission.
炎症在急性缺血性卒中(AIS)的发病机制中起重要作用。β2微球蛋白(β2M)作为AIS炎症反应潜在启动因子的作用尚不清楚。本研究旨在分析血清β2M与AIS复发风险及3个月预后的关系。共纳入205例AIS患者,收集其临床和生化特征。所有患者在卒中发病后随访3个月,发病后3个月的死亡或严重残疾情况是本研究关注的结局。我们评估了AIS患者血清β2M水平与美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分及Essen卒中风险评分(ESRS)值之间的关联。然后,我们采用受试者工作特征曲线分析计算AIS患者判别结局的最佳截断值,并采用二元逻辑回归模型评估AIS后不良结局的危险因素。我们的结果显示,血清β2M水平与ESRS值(r = 0.176,P < 0.001)和mRS评分(r = 0.402,P < 0.001)显著正相关,但β2M水平与NIHSS评分(r = 0.080,P = 0.255)或梗死体积(r = 0.013,P = 0.859)无关。在进一步研究中,我们发现121例患者(59.02%)预后不良。本研究中预测AIS 3个月预后的最佳β2M截断值为1.865 mg/l,且β2M与3个月时的不良结局独立相关(OR = 3.325,95%置信区间:1.089~10.148)。总之,我们推断血清β2M与AIS的复发风险及3个月预后正相关,但似乎与AIS的严重程度或入院时梗死灶大小无直接关系。