血清血管生成素-1 浓度不能区分缺血性脑卒中患者和以缺血性脑卒中样发作为表现而就诊于医院的患者。
Serum angiopoietin-1 concentration does not distinguish patients with ischaemic stroke from those presenting to hospital with ischaemic stroke mimics.
机构信息
Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia.
Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, 4811, Australia.
出版信息
BMC Cardiovasc Disord. 2022 Nov 4;22(1):462. doi: 10.1186/s12872-022-02918-w.
BACKGROUND
A previous study found that circulating angiopoietin-1 (angpt-1) concentrations were significantly lower in patients who had a recent ischaemic stroke compared to healthy controls. The primary aim of this study was to assess whether serum angpt-1 could be used as a diagnostic test of ischemic stroke in patients presenting to hospital as an emergency. Exploratory analyses investigated the association of proteins functionally related to angpt-1 (angpt-2, Tie-2, matrix metalloproteinase-9 and vascular endothelial growth factors A, C and D) with ischaemic stroke diagnosis.
METHODS
Patients presenting to Townsville University Hospital for emergency assessment of stroke-like symptoms were consecutively recruited and provided a blood sample. After assessment by a consultant neurologist, patients were grouped into those who did, or did not have ischaemic stroke. The potential for serum angpt-1 to diagnose ischaemic stroke was assessed using receiver operator characteristic (ROC) curves. Cross-sectional analyses appraised inter-group differences in the serum concentration of other proteins.
RESULTS
One-hundred and twenty-six patients presenting to Townsville University Hospital for emergency assessment of stroke-like symptoms were recruited (median time from symptom onset to hospital presentation: 2.6 (inter-quartile range: 1.2-4.6) hours). Serum angpt-1 had poor ability to diagnose ischaemic stroke in analyses using the whole cohort, or in sensitivity analyses (area under the ROC curve 0.51 (95% CI: 0.41-0.62) and 0.52 (95% CI: 0.39-0.64), respectively). No associations of serum angpt-1 concentration with ischaemic stroke severity, symptom duration or aetiology were observed. Serum concentrations of the other assessed proteins did not differ between patient groups.
CONCLUSIONS
Serum angpt-1 concentration is unlikely to be useful for emergency diagnosis of ischaemic stroke.
背景
先前的研究发现，与健康对照组相比，近期发生缺血性中风的患者循环血管生成素-1（angpt-1）浓度明显降低。本研究的主要目的是评估血清 angpt-1 是否可作为因疑似中风而到医院就诊的患者的缺血性中风诊断测试。探索性分析研究了与 angpt-1 功能相关的蛋白（angpt-2、Tie-2、基质金属蛋白酶-9 以及血管内皮生长因子 A、C 和 D）与缺血性中风诊断之间的关系。
方法
连续招募因疑似中风症状而到汤斯维尔大学医院急诊评估的患者，并采集其血液样本。在顾问神经病学家评估后，将患者分为患有缺血性中风和未患有缺血性中风的患者。使用接受者操作特征（ROC）曲线评估血清 angpt-1 诊断缺血性中风的能力。横断面分析评估了其他蛋白在血清浓度上的组间差异。
结果
共招募了 126 名因疑似中风症状而到汤斯维尔大学医院急诊评估的患者（从症状发作到医院就诊的中位时间：2.6 小时（四分位距：1.2-4.6））。在使用整个队列进行的分析或在敏感性分析中，血清 angpt-1 诊断缺血性中风的能力均较差（ROC 曲线下面积分别为 0.51（95%CI：0.41-0.62）和 0.52（95%CI：0.39-0.64））。未观察到血清 angpt-1 浓度与缺血性中风严重程度、症状持续时间或病因之间存在相关性。患者组之间的其他评估蛋白的血清浓度无差异。
结论
血清 angpt-1 浓度不太可能用于缺血性中风的急诊诊断。
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