血清白细胞介素-33是急性缺血性卒中出血转化和预后的新型预测生物标志物。
Serum Interleukin-33 is a Novel Predictive Biomarker of Hemorrhage Transformation and Outcome in Acute Ischemic Stroke.
作者信息
Chen Zhenlei, Hu Qingzhe, Huo Yingchao, Zhang Rongrong, Fu Qing, Qin Xinyue
机构信息
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China and Chongqing Key Laboratory of Neurobiology, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, China.
出版信息
J Stroke Cerebrovasc Dis. 2021 Feb;30(2):105506. doi: 10.1016/j.jstrokecerebrovasdis.2020.105506. Epub 2020 Dec 8.
INTRODUCTION
Hemorrhage Transformation (HT) in acute ischemic stroke (AIS) depends on multiple factors. Some studies have shown that serum interleukin-33 (IL-33) is of central significance as a neuroprotective factor. However, the relationship between serum IL-33 and HT in AIS has not been evaluated.
OBJECTIVE
To investigate the relationship between serum IL-33 concentration and HT in AIS.
METHODS
We recruited 151 consecutive non-thrombolytic patients with AIS clinically diagnosed in The First Affiliated Hospital of Chongqing Medical University from December 2018 to October 2019. If the patients showed radiographic presentation of HT within two weeks following admission, they were assigned to the HT group; others were assigned to the non-HT group. There were 40 healthy control subjects recruited during the same period. Serum IL-33 concentration was detected by ELISA and the independent risk value of HT in AIS was predicted by multivariate logistic regression. The accuracy was analyzed by receiver operating characteristic (ROC) curves. In three months after admission, the functional outcome was measured by modified Rankin scale (mRS).
RESULTS
ROC curve showed that the area under the curve (AUC) of serum IL-33 was 0.739 (95% CI: 0.657-0.821, P < .001) in predicting HT in AIS. When serum IL-33 concentration was ≤ 67.66 ng/L, the sensitivity and specificity of the prediction were 81.3% and 63%, respectively. Multivariate logistic regression analysis showed that serum IL-33 concentration ≤ 67.66 ng/L was an independent predictor of HT in AIS (OR = 5.773, 95% CI: 1.685-19.792, P = .005). The follow-up results of mRS showed a higher probability of an unfavorable outcome in those with HT compared to those without HT (OR = 6.520, 95% CI: 2.530-16.803, P < .001).
CONCLUSIONS
HT in AIS is negatively correlated with outcome. Furthermore, serum IL-33 is an independent predictive biomarker of HT and outcome in AIS.
引言
急性缺血性卒中（AIS）中的出血转化（HT）取决于多种因素。一些研究表明，血清白细胞介素-33（IL-33）作为一种神经保护因子具有核心意义。然而，血清IL-33与AIS中HT之间的关系尚未得到评估。
目的
探讨血清IL-33浓度与AIS中HT的关系。
方法
我们招募了2018年12月至2019年10月在重庆医科大学附属第一医院临床诊断的151例连续非溶栓AIS患者。如果患者在入院后两周内出现HT的影像学表现，则将其分配到HT组；其他患者分配到非HT组。同期招募了40名健康对照者。采用酶联免疫吸附测定法（ELISA）检测血清IL-33浓度，并通过多因素logistic回归预测AIS中HT的独立风险值。通过受试者工作特征（ROC）曲线分析准确性。入院后三个月，采用改良Rankin量表（mRS）测量功能结局。
结果
ROC曲线显示，血清IL-33预测AIS中HT的曲线下面积（AUC）为0.739（95%CI：0.657-0.821，P<.001）。当血清IL-33浓度≤67.66 ng/L时，预测的敏感性和特异性分别为81.3%和63%。多因素logistic回归分析显示，血清IL-33浓度≤67.66 ng/L是AIS中HT的独立预测因子（OR = 5.773，95%CI：1.685-19.792，P =.005）。mRS的随访结果显示，与无HT的患者相比，HT患者预后不良的可能性更高（OR = 6.520，95%CI：2.530-16.803，P<.001）。
结论
AIS中的HT与结局呈负相关。此外，血清IL-33是AIS中HT和结局的独立预测生物标志物。
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