Li Weili, Yuan Shuhua, Sui Xueqin, Bian Hetao, Wei Ming, Chen Zhiying, Shao Haitao, Shi Wenjuan, Shi Shuhai, Ji Xunming
Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.
Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, China.
CNS Neurosci Ther. 2022 Jul;28(7):999-1007. doi: 10.1111/cns.13830. Epub 2022 Mar 26.
Early neurological deterioration (END) is an important factor that affects prognosis in patients with acute ischemic stroke. We explored the relationship between serum occludin levels after successful reperfusion and END in patients treated with endovascular thrombectomy (EVT).
We prospectively enrolled 120 stroke patients who underwent EVT with successful reperfusion. Enzyme-linked immunosorbent assay was used to detect the serum occludin levels on admission and within 1 h after successful reperfusion. Receiver operating characteristic curves (ROC) and regression analysis were used to compare the relationship between serum occludin and END after thrombectomy.
Among the 120 patients, 36 (30%) experienced END. The END group had higher serum occludin levels than the non-END group after successful reperfusion [4.31 (3.71-5.38) vs 6.32 (5.88-6.99), p < 0.001]. The ROC curve showed that postoperative serum occludin levels had a significant prediction value for END (AUC: 0.86, p < 0.001). Regression analysis showed that serum occludin was an independent risk factor for END in EVT patients (adjusted odds ratio: 4.46, 95% confidence interval: 1.92-10.32; p < 0.001).
The higher serum occludin levels were strongly related to END after successful reperfusion. Serum occludin may be an independent risk factor for END in EVT patients.
早期神经功能恶化(END)是影响急性缺血性卒中患者预后的重要因素。我们探讨了血管内血栓切除术(EVT)治疗的患者成功再灌注后血清闭合蛋白水平与END之间的关系。
我们前瞻性纳入了120例接受EVT且成功再灌注的卒中患者。采用酶联免疫吸附测定法检测入院时及成功再灌注后1小时内的血清闭合蛋白水平。使用受试者工作特征曲线(ROC)和回归分析来比较血栓切除术后血清闭合蛋白与END之间的关系。
在120例患者中,36例(30%)发生了END。成功再灌注后,END组的血清闭合蛋白水平高于非END组[4.31(3.71 - 5.38)对6.32(5.88 - 6.99),p < 0.001]。ROC曲线显示,术后血清闭合蛋白水平对END具有显著的预测价值(AUC:0.86,p < 0.001)。回归分析表明,血清闭合蛋白是EVT患者发生END的独立危险因素(调整后的优势比:4.46,95%置信区间:1.92 - 10.32;p < 0.001)。
成功再灌注后血清闭合蛋白水平升高与END密切相关。血清闭合蛋白可能是EVT患者发生END的独立危险因素。