再灌注治疗的中风患者中的吸烟悖论与内皮功能障碍有关。
The Smoking Paradox in Stroke Patients Under Reperfusion Treatment Is Associated With Endothelial Dysfunction.
作者信息
Iglesias-Rey Ramón, Custodia Antía, Alonso-Alonso Maria Luz, López-Dequidt Iria, Rodríguez-Yáñez Manuel, Pumar José M, Castillo José, Sobrino Tomás, Campos Francisco, da Silva-Candal Andres, Hervella Pablo
机构信息
Neuroimaging and Biotechnology Laboratory, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.
Clinical Neurosciences Research Laboratories, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.
出版信息
Front Neurol. 2022 Mar 24;13:841484. doi: 10.3389/fneur.2022.841484. eCollection 2022.
OBJECTIVE
This study aimed to explore the association between smoking habit and the serum levels of soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK), in relation with the functional outcome of patients with acute ischemic stroke undergoing reperfusion treatment.
METHODS
Observational and retrospective study of a series of patients with acute ischemic stroke subjected to reperfusion treatments. Clinical, analytical, and neuroimaging parameters were analyzed. The main endpoint was the functional outcome at 3 months, measured by the modified Ranking Scale (mRS). Logistic regression models were used to analyze the association between smoking and sTWEAK levels with functional outcome and leukoaraiosis.
RESULTS
The results showed that smoking habit was associated with a good functional outcome at 3 months in patients with stroke (OR: 3.52; 95% CI: 1.03-11.9; = 0.044). However, this independent association was lost after adjusting by sTWEAK levels (OR 1.73; 95% CI: 0.86-13.28; = 0.116). sTWEAK levels were significantly lower in smoker patients [4015.5 (973.66-7921.83) pg/ml vs. 5,628 (2,848-10,202) pg/ml, < 0.0001], while sTWEAK levels were significantly higher in patients with poor functional outcomes at 3 months [10,284 (7,388-13.247) pg/ml vs. 3,405 (2,329-6,629) pg/ml, < 0.0001].
CONCLUSION
The decrease in sTWEAK levels was associated with a good functional outcome in smoker patients with stroke undergoing reperfusion therapy.
目的
本研究旨在探讨吸烟习惯与可溶性肿瘤坏死因子样凋亡弱诱导剂（sTWEAK）血清水平之间的关联，以及其与接受再灌注治疗的急性缺血性脑卒中患者功能结局的关系。
方法
对一系列接受再灌注治疗的急性缺血性脑卒中患者进行观察性和回顾性研究。分析临床、分析和神经影像学参数。主要终点是3个月时的功能结局，采用改良Rankin量表（mRS）测量。使用逻辑回归模型分析吸烟与sTWEAK水平与功能结局和白质疏松症之间的关联。
结果
结果显示，吸烟习惯与脑卒中患者3个月时良好的功能结局相关（比值比：3.52；95%置信区间：1.03 - 11.9；P = 0.044）。然而，在根据sTWEAK水平进行调整后，这种独立关联消失（比值比1.73；95%置信区间：0.86 - 13.28；P = 0.116）。吸烟者患者的sTWEAK水平显著较低[4015.5（973.66 - 7921.83）pg/ml对5628（2848 - 10202）pg/ml，P < 0.0001]，而3个月时功能结局较差的患者sTWEAK水平显著较高[10284（7388 - 13247）pg/ml对3405（2329 - 6629）pg/ml，P < 0.0001]。
结论
sTWEAK水平降低与接受再灌注治疗的吸烟脑卒中患者良好的功能结局相关。
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