Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
Department of Neurology, Hospital Clínico Universitario, Santiago de Compostela, Spain.
Stroke Vasc Neurol. 2021 Dec;6(4):528-535. doi: 10.1136/svn-2020-000684. Epub 2021 Mar 23.
To study the association between early growth of haematoma with biomarkers of endothelial dysfunction such as leukoaraiosis (LA) and the soluble tumour necrosis factor-like weak inducer of apoptosis (sTWEAK) in patients with intracerebral haemorrhage (ICH).
This is a retrospective observational study of patients with nontraumatic ICH. Clinical and biochemical parameters were analysed. sTWEAK levels were measured by ELISA. LA was analysed in the hemisphere without haemorrhage to avoid interference with the acute injury. The main endpoint was the haematoma growth evaluated by the difference in volume between the second and the initial neuroimage. Poor functional outcome, defined as a modified Rankin Scale >2 at 3 months, was considered as secondary endpoint. Receiver operating characteristic curve analysis was performed to stablish the best cut-off for sTWEAK levels associated with haematoma growth.
We included 653 patients with ICH in our analysis (71.1±11.9 years, 44% women). Haematoma growth was observed in 188 patients (28.8%). sTWEAK levels ≥5600 pg/mL predicted ICH growth with a sensitivity of 84% and a specificity of 87%. sTWEAK levels ≥5600 pg/mL and the presence of LA were associated with haematoma growth (OR: 42.46; (CI 95% 22.67 to 79.52) and OR: 2.73 (CI 95% 1.39 to 5.34), respectively). Also, the presence of LA (OR: 4.31 (CI 95% 2.89 to 6.42)) and the interaction between ICH growth and sTWEAK (OR: 2.23 (CI 95% 1.40 to 3.55)) were associated with poor functional outcome at 3 months.
sTWEAKs, together with the presence and grade of LA, are biomarkers able to predict ICH growth and poor functional outcome in patients with ICH.
研究脑出血（ICH）患者血肿早期增长与血管内皮功能障碍生物标志物白细胞淤滞症（LA）和可溶性肿瘤坏死因子样弱凋亡诱导剂（sTWEAK）之间的关系。
这是一项对非外伤性 ICH 患者进行的回顾性观察性研究。分析了临床和生化参数。通过 ELISA 测量 sTWEAK 水平。为避免与急性损伤干扰，在无出血的对侧半脑分析 LA。主要终点是通过第二次和初始神经图像之间的体积差异评估血肿增长。将 3 个月时改良 Rankin 量表评分＞2 定义为不良功能结局，作为次要终点。进行受试者工作特征曲线分析，以确定与血肿增长相关的 sTWEAK 水平的最佳截断值。
我们对 653 例 ICH 患者进行了分析（71.1±11.9 岁，44%为女性）。188 例患者出现血肿增长（28.8%）。sTWEAK 水平≥5600 pg/mL 预测 ICH 增长，敏感性为 84%，特异性为 87%。sTWEAK 水平≥5600 pg/mL 和存在 LA 与血肿增长相关（OR：42.46；95%CI 22.67 至 79.52）和 OR：2.73（95%CI 1.39 至 5.34）。此外，LA 的存在（OR：4.31；95%CI 2.89 至 6.42）和 ICH 增长与 sTWEAK 之间的相互作用（OR：2.23；95%CI 1.40 至 3.55）与 3 个月时的不良功能结局相关。
sTWEAKs 与 LA 的存在和分级一起，是能够预测 ICH 增长和 ICH 患者不良功能结局的生物标志物。
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