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血清钙通道亚基 α2δ-1 浓度与急性自发性脑出血患者的转归

Serum calcium channel subunit α2δ-1 concentrations and outcomes in patients with acute spontaneous intracerebral hemorrhage.

机构信息

Department of Emergency Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 261 Huansha Road, Hangzhou 310006, China.

Department of Urology, Hangzhou Ninth People's Hospital, 98 Yilong Road, Hangzhou 311225, China.

出版信息

Clin Chim Acta. 2022 Feb 15;527:17-22. doi: 10.1016/j.cca.2022.01.002. Epub 2022 Jan 7.

Abstract

BACKGROUND

Voltage-gated calcium channel subunit α2δ-1 plays an important role in acute brain injury. We attempted to investigate whether serum α2δ-1 subunit concentrations are correlated with severity and prognosis following intracerebral hemorrhage (ICH).

METHODS

Serum α2δ-1 subunit concentrations were quantified in 103 ICH patients and 103 healthy controls. National Institutes of Health Stroke Scale (NIHSS) score and hematoma volume were estimated for assessing illness severity. Modified Rankin scale score of 3-6 at 90 days after stroke onset was defined as a worse outcome.

RESULTS

Serum α2δ-1 subunit concentrations were markedly higher in patients than in controls (median, 875.1 vs. 209.3 pg/ml). Serum α2δ-1 subunit concentrations of patients were tightly correlated with NIHSS score (r = 0.589) and hematoma volume (r = 0.594). Serum α2δ-1 subunit concentrations ≥ 875.1 pg/ml independently discriminated development of 90-day poor outcome with odds ratio of 5.228 (95% CI, 2.201-12.418) and area under the receiver operating characteristic curve of 0.794 (95% CI, 0.703-0.867). Serum α2δ-1 subunit concentrations > 973.4 pg/ml predicted 90-day poor outcome with 64.0% sensitivity and 90.6% specificity. The prognostic predictive ability of serum α2δ-1 concentrations was equivalent to those of NIHSS score and hematoma volume (both P > 0.05), and serum α2δ-1 concentrations also significantly improved the prognostic predictive capabilities of NIHSS score and hematoma volume (both P < 0.05).

CONCLUSIONS

Serum α2δ-1 subunit concentrations are intimately correlated with illness severity and are independently associated with poor 90-day outcome, substantializing serum α2δ-1 subunit as a potential prognostic biomarker for ICH.

摘要

背景

电压门控钙通道亚基 α2δ-1 在急性脑损伤中发挥重要作用。我们试图研究血清 α2δ-1 亚基浓度是否与脑出血(ICH)后的严重程度和预后相关。

方法

定量检测 103 例 ICH 患者和 103 例健康对照者的血清 α2δ-1 亚基浓度。采用国立卫生研究院卒中量表(NIHSS)评分和血肿体积评估疾病严重程度。卒中发病后 90 天改良 Rankin 量表评分 3-6 定义为预后不良。

结果

与对照组相比,患者的血清 α2δ-1 亚基浓度明显升高(中位数 875.1 比 209.3 pg/ml)。患者的血清 α2δ-1 亚基浓度与 NIHSS 评分(r=0.589)和血肿体积(r=0.594)呈强相关。血清 α2δ-1 亚基浓度≥875.1 pg/ml 可独立预测 90 天不良预后,优势比为 5.228(95%可信区间,2.201-12.418),受试者工作特征曲线下面积为 0.794(95%可信区间,0.703-0.867)。血清 α2δ-1 亚基浓度>973.4 pg/ml 预测 90 天不良预后的灵敏度为 64.0%,特异性为 90.6%。血清 α2δ-1 浓度的预后预测能力与 NIHSS 评分和血肿体积相当(均 P>0.05),血清 α2δ-1 浓度也显著提高了 NIHSS 评分和血肿体积的预后预测能力(均 P<0.05)。

结论

血清 α2δ-1 亚基浓度与疾病严重程度密切相关,与不良 90 天预后独立相关,证实血清 α2δ-1 亚基作为 ICH 的潜在预后生物标志物。

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