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tau、S100B 和 NSE 作为急性脑血管事件的血液生物标志物。

Tau, S100B and NSE as Blood Biomarkers in Acute Cerebrovascular Events.

机构信息

Department of Neurology, NeuroCenter, Kuopio University Hospital, Kuopio, Finland

Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.

出版信息

In Vivo. 2020 Sep-Oct;34(5):2577-2586. doi: 10.21873/invivo.12075.

Abstract

BACKGROUND/AIM: We aimed to analyze the diagnostic value of total tau (T-tau), S-100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE) as blood-based biomarkers in acute ischemic stroke (AIS) or transient ischemic attack (TIA), and their correlation with symptom severity, infarct size, etiology and outcome.

PATIENTS AND METHODS

A total of 102 patients with stroke and 35 with TIA were analyzed. Subacute (63.8±50.1 h) plasma T-tau was measured with the single-molecule array (Simoa) method and NSE and S100B were evaluated for comparison. We evaluated biomarkers associations with: (i) diagnosis of AIS or TIA, (ii) cerebral infarction volume in the brain computed tomography, (iii) stroke etiology, (iv) clinical stroke severity and (iv) functional outcome after three months.

RESULTS

T-tau was higher in patients with stroke [1.0 pg/ml (IQR=0.3-2.2)] than with TIA [0.5 pg/ml (IQR=0.2-1.0), p=0.02]. The levels of S100B were also increased in stroke [0.082 μg/l (IQR=0.049-0.157)] patients compared to TIA patients [0.045 μg/l (IQR=0.03-0.073), p<0.001]. However, when the results were adjusted for confounders, significance was lost. Serum levels of NSE among patients with AIS [11.85 μg/l (IQR=9.30-16.14)] compared to those with TIA [10.96 μg/l (IQR=7.98-15.33), p=0.30] were equal. T-tau and S100B concentrations significantly correlated with cerebral infarction volume (r=0.412, p<0.001) and (r=0.597, p<0.001), also after corrections (p<0.001). mRS scores at three-month follow-up correlated with T-tau (r=0.248, p=0.016) and S100B concentrations (r=0.205, p=0.045).

CONCLUSION

For the diagnosis of TIA vs. AIS, blood T-tau and S100B concentrations discriminated only modestly. Additionally, groups were not separable after measuring of T-tau and S100B levels in the blood. T-tau and S100B concentrations correlated with the infarct size, but were not alone predictive for functional outcome at 3 months.

摘要

背景/目的:我们旨在分析总 tau(T-tau)、S-100 钙结合蛋白 B(S100B)和神经元特异性烯醇化酶(NSE)作为急性缺血性中风(AIS)或短暂性脑缺血发作(TIA)的基于血液的生物标志物的诊断价值,及其与症状严重程度、梗死体积、病因和结局的相关性。

患者和方法

共分析了 102 例中风患者和 35 例 TIA 患者。采用单分子阵列(Simoa)法测定亚急性期(63.8±50.1 小时)血浆 T-tau,并评估 NSE 和 S100B 进行比较。我们评估了生物标志物与以下方面的相关性:(i)AIS 或 TIA 的诊断,(ii)脑计算机断层扫描中的脑梗死体积,(iii)中风病因,(iv)临床中风严重程度和(iv)三个月后的功能结局。

结果

中风患者的 T-tau 水平较高[1.0 pg/ml(IQR=0.3-2.2)],TIA 患者[0.5 pg/ml(IQR=0.2-1.0),p=0.02]。S100B 的水平在中风患者[0.082 μg/l(IQR=0.049-0.157)]中也升高,与 TIA 患者[0.045 μg/l(IQR=0.03-0.073)相比,p<0.001]。然而,当结果经过混杂因素校正后,意义就消失了。与 TIA 患者[11.85 μg/l(IQR=9.30-16.14)相比,AIS 患者的血清 NSE 水平[10.96 μg/l(IQR=7.98-15.33),p=0.30]相等。T-tau 和 S100B 浓度与脑梗死体积(r=0.412,p<0.001)和(r=0.597,p<0.001)显著相关,校正后也存在相关性(p<0.001)。在三个月的随访中,mRS 评分与 T-tau(r=0.248,p=0.016)和 S100B 浓度(r=0.205,p=0.045)相关。

结论

对于 TIA 与 AIS 的诊断,血液 T-tau 和 S100B 浓度的区分度仅适中。此外,在测量血液中的 T-tau 和 S100B 水平后,两组也无法分离。T-tau 和 S100B 浓度与梗死体积相关,但不能单独预测 3 个月时的功能结局。

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