Li Sijia, Wang Wenjuan, Zhang Qian, Wang Yu, Wang Anxin, Zhao Xingquan
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Front Neurol. 2021 Aug 30;12:677696. doi: 10.3389/fneur.2021.677696. eCollection 2021.
Spontaneous intracerebral hemorrhage (ICH) is associated with high rates of mortality and morbidity. Alkaline phosphatase (ALP) is related to increased risk of cardiovascular events and is also closely associated with adverse outcomes after ischemic or hemorrhagic stroke. However, there are limited data about the effect of ALP on clinical outcomes after ICH. Therefore, we aimed to investigate the relationship between serum ALP level and prognosis in ICH patients. From January 2014 to September 2016, 939 patients with spontaneous ICH were enrolled in our study from 13 hospitals in Beijing. Patients were categorized into four groups based on the ALP quartiles (Q1, Q2, Q3, Q4). The main outcomes were 30-day, 90-day, and 1-year poor functional outcomes (modified Rankin Scale score of 3-6). Multivariable logistic regression and interaction analyses were performed to evaluate the relationships between ALP and clinical outcomes after ICH. In the logistic regression analysis, compared with the third quartile of ALP, the adjusted odds ratios of the Q1, Q2, and Q4 for 30-day poor functional outcome were 1.31 (0.80-2.15), 1.16 (0.71-1.89), and 2.16 (1.32-3.55). In terms of 90-day and 1-year poor functional outcomes, the risks were significantly higher in the highest quartile of ALP compared with the third quartile after adjusting the confounding factors [90-day: highest quartile OR = 1.86 (1.12-3.10); 1-year: highest quartile OR = 2.26 (1.34-3.80)]. Moreover, there was no significant interaction between ALP and variables like age or sex. High ALP level (>94.8 U/L) was independently associated with 30-day, 90-day, and 1-year poor functional outcomes in ICH patients. Serum ALP might serve as a predictor for poor functional outcomes after ICH onset.
自发性脑出血（ICH）与高死亡率和高发病率相关。碱性磷酸酶（ALP）与心血管事件风险增加有关，并且也与缺血性或出血性中风后的不良结局密切相关。然而，关于ALP对ICH后临床结局影响的数据有限。因此，我们旨在研究ICH患者血清ALP水平与预后之间的关系。2014年1月至2016年9月，我们从北京的13家医院纳入了939例自发性ICH患者。根据ALP四分位数（Q1、Q2、Q3、Q4）将患者分为四组。主要结局为30天、90天和1年时功能结局不良（改良Rankin量表评分为3 - 6分）。进行多变量逻辑回归和交互分析以评估ALP与ICH后临床结局之间的关系。在逻辑回归分析中，与ALP第三四分位数相比，Q1、Q2和Q4在30天时功能结局不良的校正比值比分别为1.31（0.80 - 2.15）、1.16（0.71 - 1.89）和2.16（1.32 - 3.55）。就90天和1年时功能结局不良而言，在调整混杂因素后，ALP最高四分位数的风险显著高于第三四分位数[90天：最高四分位数OR = 1.86（1.12 - 3.10）；1年：最高四分位数OR = 2.26（1.34 - 3.开0）]。此外，ALP与年龄或性别等变量之间无显著交互作用。高ALP水平（>94.8 U/L）与ICH患者30天、90天和1年时功能结局不良独立相关。血清ALP可能作为ICH发病后功能结局不良的预测指标。
