Department of Neurology, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
In Vivo. 2020 Sep-Oct;34(5):2577-2586. doi: 10.21873/invivo.12075.
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.
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.
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).
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.
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。
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。
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。
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。