血清神经丝轻链水平与接受血管内治疗的大血管闭塞患者的卒中严重程度和功能结局相关。
Serum neurofilament light chain levels are associated with stroke severity and functional outcome in patients undergoing endovascular therapy for large vessel occlusion.
机构信息
Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
出版信息
J Neurol Sci. 2021 Oct 15;429:118063. doi: 10.1016/j.jns.2021.118063. Epub 2021 Sep 1.
BACKGROUND
We aimed to analyze serum neurofilament light chain (sNfL) levels in patients undergoing endovascular therapy (EVT) for anterior circulation large vessel occlusion (acLVO).
METHODS
Prospective study of consecutive patients with acLVO receiving EVT (12/2020-01/2021). sNfL was serially measured prior to and at 30-min, 6-h, 12-h, 24-h, 48-h and 7-days following EVT. ANOVA and Spearman correlation were run to assess sNfL levels (ie, absolute values) and ΔsNfL levels (ie, absolute values subtracted by baseline value) and their association with clinical (ie, NIHSS), imaging (ie, ASPECTS) surrogates of stroke severity as well as functional outcome (ie, mRS) at 90-days.
RESULTS
175 sNfL samples were retrieved from 25 patients. While there were no differences among serial sNfL levels in the first 12-h post-EVT, a constant increase was observed afterwards (maximum day 7, median: 383 [IQR, 209-907] pg/mL, p < 0.001). ΔsNfL showed a constant increase from 30-min measurement onwards peaking after 7 days (median 363.5 [IQR, 114.3-851.1] pg/mL). sNfL levels at 7 days correlated with ASPECTS post-EVT (r = -0.59, p < 0.001), NIHSS at discharge (r = -0.50, p = 0.011) and mRS at 90-days (r = 0.45, p = 0.027).
CONCLUSIONS
Serum NFL may complement established clinical and imaging predictors of treatment response and functional outcome in stroke patients undergoing EVT for acLVO.
背景
本研究旨在分析接受血管内治疗（EVT）的前循环大血管闭塞（acLVO）患者的血清神经丝轻链（sNfL）水平。
方法
前瞻性连续研究了 2020 年 12 月至 2021 年 1 月接受 EVT 的 acLVO 患者。在 EVT 前及 EVT 后 30 分钟、6 小时、12 小时、24 小时、48 小时和 7 天，连续测量 sNfL。使用方差分析和 Spearman 相关性分析评估 sNfL 水平（即绝对值）和ΔsNfL 水平（即绝对值减去基线值）及其与临床（即 NIHSS）、影像学（即 ASPECTS）等卒中严重程度替代指标以及 90 天时的功能结局（即 mRS）之间的关系。
结果
共从 25 例患者中获取了 175 份 sNfL 样本。尽管 EVT 后前 12 小时的连续 sNfL 水平没有差异，但之后观察到持续升高（第 7 天最高，中位数：383 [IQR，209-907] pg/mL，p < 0.001）。ΔsNfL 自 30 分钟测量开始持续升高，第 7 天达到峰值（中位数 363.5 [IQR，114.3-851.1] pg/mL）。第 7 天 sNfL 水平与 EVT 后 ASPECTS（r=-0.59，p < 0.001）、出院时 NIHSS（r=-0.50，p=0.011）和 90 天 mRS（r=0.45，p=0.027）相关。
结论
血清 NFL 可能补充了接受 EVT 的 acLVO 患者治疗反应和功能结局的既定临床和影像学预测因素。
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