急性卒中阶段ASPECTS的临床与分子关联
Clinical and molecular correlates of the ASPECTS in the acute phase of stroke.
作者信息
Mourão Aline Mansueto, Vicente Laélia Cristina Caseiro, Abreu Mery Natali Silva, Sant'anna Romeu Vale, DE Meira Fidel Castro Alves, Xavier Rodrigo Menezes de Brito, Tanure Marco Túlio de Azevedo, Vieira Erica Leandro Marciano, DE Souza Leonardo Cruz, Miranda Aline Silva de, Rachid Milene Alvarenga, Teixeira Antônio Lucio
机构信息
Unidade de Acidente Vascular Cerebral, Hospital Risoleta Tolentino Neves, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
出版信息
Arq Neuropsiquiatr. 2020 May;78(5):262-268. doi: 10.1590/0004-282x20200001. Epub 2020 May 29.
BACKGROUND
The Alberta Stroke Program Early CT Score (ASPECTS) scale was developed for monitoring early ischemic changes on CT, being associated with clinical outcomes. The ASPECTS can also associate with peripheral biomarkers that reflect the pathophysiological response of the brain to the ischemic stroke.
OBJECTIVE
To investigate the association between peripheral biomarkers with the Alberta Stroke Program Early CT Score (ASPECTS) in individuals after ischemic stroke.
METHODS
Patients over 18 years old with acute ischemic stroke were enrolled in this study. No patient was eligible for thrombolysis. The patients were submitted to non-contrast CT in the first 24 hours of admission, being the Alberta Stroke Program Early CT Score and clinical and molecular evaluations applied on the same day. The National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale and the Mini-Mental State Examination for clinical evaluation were also applied to all subjects. Plasma levels of BDNF, VCAM-1, VEGF, IL-1β, sTNFRs and adiponectin were determined by ELISA.
RESULTS
Worse neurological impairment (NIHSS), cognitive (MEEM) and functional (Rankin) performance was observed in the group with changes in the NCTT. Patients with NCTT changes also exhibited higher levels of IL-1β and adiponectin. In the linear multivariate regression, an adjusted R coefficient of 0.515 was found, indicating adiponectin and NIHSS as independent predictors of ASPECTS.
CONCLUSION
Plasma levels of adiponectin are associated with the ASPECTS scores.
背景
阿尔伯塔卒中项目早期CT评分（ASPECTS）量表旨在监测CT上的早期缺血性改变，并与临床结局相关。ASPECTS还可与反映大脑对缺血性卒中病理生理反应的外周生物标志物相关。
目的
研究缺血性卒中患者外周生物标志物与阿尔伯塔卒中项目早期CT评分（ASPECTS）之间的关联。
方法
纳入年龄超过18岁的急性缺血性卒中患者。无患者符合溶栓条件。患者在入院后24小时内接受非增强CT检查，并在同一天进行阿尔伯塔卒中项目早期CT评分以及临床和分子评估。所有受试者还应用了美国国立卫生研究院卒中量表（NIHSS）、改良Rankin量表和简易精神状态检查进行临床评估。通过酶联免疫吸附测定法测定血浆中脑源性神经营养因子（BDNF）、血管细胞黏附分子-1（VCAM-1）、血管内皮生长因子（VEGF）、白细胞介素-1β（IL-1β）、可溶性肿瘤坏死因子受体（sTNFRs）和脂联素的水平。
结果
在非对比CT有改变的组中观察到更严重的神经功能缺损（NIHSS）、认知（简易精神状态检查）和功能（Rankin）表现。非对比CT有改变的患者还表现出更高水平的IL-1β和脂联素。在线性多变量回归中，发现调整后的R系数为0.515，表明脂联素和NIHSS是ASPECTS的独立预测因子。
结论
脂联素血浆水平与ASPECTS评分相关。
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