Park Seongjoo, Choi Eun-Su, Jung Hee-Won, Lee Ji-Youn, Park Jin-Woo, Bang Jae-Seung, Jeon Yeong-Tae
Department of Anaesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea.
Department of Anaesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Korea.
J Clin Med. 2022 May 25;11(11):2981. doi: 10.3390/jcm11112981.
This study evaluated the relationship between the preoperative alkaline phosphatase (ALP) level and major postoperative neurological complications in patients undergoing cerebral bypass surgery. This was a retrospective analysis of a prospective database of all patients undergoing cerebral bypass surgery after a diagnosis of cerebrovascular stenosis or occlusion between May 2003 and August 2017. The patients were divided into tertiles based on serum alkaline phosphatase (ALP) levels (low: <63, intermediate: 63~79, and high: ALP > 79 IU/mL). The incidence of neurological events according to ALP level was analyzed. The study analyzed 211 cases. The incidence of acute infarction was highest in the third serum ALP tertile (5.7% vs. 2.9% vs. 16.9% in the first, second, and third tertile, respectively, p = 0.007). Logistic regression analysis showed that the third tertile of serum ALP was an independent predictor of acute cerebral infarction (odds ratio 3.346, 95% confidence interval 1.026−10.984, p = 0.045). On Kaplan−Meier time-to-event curves, the incidence of acute infarction increased significantly with ALP (log rank = 0.048). Preoperative serum ALP level can be used as a biomarker to predict acute cerebral infarction in patients undergoing cerebral bypass surgery for vascular stenosis or occlusion.
本研究评估了行脑搭桥手术患者术前碱性磷酸酶（ALP）水平与术后主要神经并发症之间的关系。这是一项对2003年5月至2017年8月期间所有诊断为脑血管狭窄或闭塞后行脑搭桥手术患者的前瞻性数据库进行的回顾性分析。根据血清碱性磷酸酶（ALP）水平将患者分为三分位数（低：<63，中等：63~79，高：ALP>79 IU/mL）。分析了根据ALP水平的神经事件发生率。该研究分析了211例病例。急性梗死发生率在血清ALP三分位数中最高（分别为16.9%，而第一、第二三分位数分别为2.9%和5.7%，p = 0.007）。逻辑回归分析显示，血清ALP的第三三分位数是急性脑梗死的独立预测因素（比值比3.346，95%置信区间1.026−10.984，p = 0.045）。在Kaplan−Meier事件发生时间曲线上，急性梗死发生率随ALP显著增加（对数秩=0.048）。术前血清ALP水平可作为预测因血管狭窄或闭塞而行脑搭桥手术患者急性脑梗死的生物标志物。
