Department of Neurosurgery, Institute of Biomedical Sciences, Tokushima University, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
Emergency and Critical Care Medicine, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
J Stroke Cerebrovasc Dis. 2021 Mar;30(3):105561. doi: 10.1016/j.jstrokecerebrovasdis.2020.105561. Epub 2020 Dec 24.
Urinary titin is a biomarker of muscle atrophy, which is a serious complication after stroke. However, there are currently no clinical data regarding urinary titin in stroke patients.
Consecutive stroke patients admitted to the stroke care unit were included. Spot urine samples were collected immediately after admission, and on days 3, 5, and 7. The primary outcome was the trend of urinary titin in patients after acute stroke. The secondary outcomes included the association between the peak urinary titin level and the modified Rankin Scale (mRS) score, the National Institutes of Health Stroke Scale (NIHSS) score, and the Barthel index (BI) upon hospital discharge. Multivariate analysis was adjusted for age, sex, NIHSS at admission, and the peak urinary titin to predict poor outcome (mRS 3-6).
Forty-one patients were included (29 male; age, 68 ± 15 years), 29 had ischemic stroke, 8 had intracerebral hemorrhage, and 4 had subarachnoid hemorrhage. The levels of urinary titin on days 1, 3, 5, and 7 were 9.9 (4.7-21.1), 16.2 (8.6-22.0), 8.9 (4.8-15.2), and 8.7 (3.6-16.2) pmol/mg Cr, respectively. The peak urinary titin level was associated with the mRS score (r = 0.55, p < 0.01), the NIHSS score (r = 0.72, p < 0.01), and the BI (r = -0.59, p < 0.01) upon hospital discharge. In multivariate analysis, the peak urinary titin was associated with poor outcome (p = 0.03).
Urinary titin rapidly increased after stroke and was associated with impaired functional outcomes at hospital discharge.
尿titin 是肌肉萎缩的生物标志物，肌肉萎缩是中风后的严重并发症。然而，目前尚无中风患者尿 titin 的临床数据。
纳入连续入住中风病房的中风患者。入院后立即采集尿液标本，第 3、5、7 天采集尿液标本。主要结局是急性中风后患者尿 titin 的趋势。次要结局包括尿 titin 峰值水平与改良 Rankin 量表（mRS）评分、国立卫生研究院卒中量表（NIHSS）评分和出院时 Barthel 指数（BI）之间的相关性。多元分析调整了年龄、性别、入院时 NIHSS 和尿 titin 峰值，以预测不良结局（mRS 3-6）。
共纳入 41 例患者（29 例男性，年龄 68±15 岁），29 例为缺血性中风，8 例为脑出血，4 例为蛛网膜下腔出血。第 1、3、5、7 天尿 titin 水平分别为 9.9（4.7-21.1）、16.2（8.6-22.0）、8.9（4.8-15.2）和 8.7（3.6-16.2）pmol/mg Cr。尿 titin 峰值与 mRS 评分（r=0.55，p<0.01）、入院时 NIHSS 评分（r=0.72，p<0.01）和出院时 BI（r=-0.59，p<0.01）相关。多元分析中，尿 titin 峰值与不良结局相关（p=0.03）。
中风后尿 titin 迅速升高，并与出院时的功能结局不良相关。
