Ling Chenhan, Cao Shenglong, Kong Xiangjie
Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University, Hangzhou Zhejiang Province 310009, China.
Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University, Hangzhou Zhejiang Province 310009, China.
J Clin Neurosci. 2022 May;99:164-168. doi: 10.1016/j.jocn.2021.10.041. Epub 2022 Mar 11.
hemorrhagic transformation is a serious complication of acute ischemic stroke, which may lead to poor prognosis and delayed use of anticoagulant therapy.
125 patients with cerebral infarction from December 2019 to December 2020 in the Second Affiliated Hospital of Zhejiang University were selected. All patients did not receive intravascular therapy, intravenous thrombolysis and other reperfusion treatment; and the relevant laboratory data were collected within 24 h after admission. At the same time, 15 healthy subjects were selected as the research objects for prospective analysis. Hemorrhagic transformation (HT) was defined as a condition in which computed tomography (CT) did not indicate bleeding at admission, but follow-up magnetic resonance imaging (MRI) or CT showed hemorrhage. The patients were divided into HT group (n = 50) and non-HT group (n = 75) according to whether there was HT after admission. The concentrations of FSTL1 and MMP-9 in peripheral blood of the two groups were detected.
The concentrations of FSTL1 and MMP-9 in acute cerebral infarction (ACI) group were significantly higher than those in control group. However the HT group had a higher concentration of FSTL1 and MMP-9 than the non-HT group. The serum FSTL1 and MMP-9 were independent risk factors for hemorrhagic transformation. The area under the ROC curve of FSTL1 and MMP-9 in diagnosis of HT was 0.809 and 0.856 respectively, and their combined value was 0.923.
The high levels of FSTL1 and MMP-9 had strong correlation with HT in ACI patients.
出血性转化是急性缺血性卒中的一种严重并发症，可能导致预后不良以及抗凝治疗的延迟使用。
选取浙江大学医学院附属第二医院2019年12月至2020年12月期间的125例脑梗死患者。所有患者均未接受血管内治疗、静脉溶栓等再灌注治疗；入院后24小时内收集相关实验室数据。同时，选取15名健康受试者作为研究对象进行前瞻性分析。出血性转化（HT）定义为入院时计算机断层扫描（CT）未显示出血，但随访磁共振成像（MRI）或CT显示出血的情况。根据入院后是否发生HT将患者分为HT组（n = 50）和非HT组（n = 75）。检测两组外周血中FSTL1和MMP-9的浓度。
急性脑梗死（ACI）组FSTL1和MMP-9的浓度显著高于对照组。然而，HT组FSTL1和MMP-9的浓度高于非HT组。血清FSTL1和MMP-9是出血性转化的独立危险因素。FSTL1和MMP-9诊断HT的ROC曲线下面积分别为0.809和0.856，两者联合值为0.923。
ACI患者中FSTL1和MMP-9的高水平与HT密切相关。
