神经丝轻链与中重度缺血性卒中的临床结局及出血性转化相关。
Neurofilament light is associated with clinical outcome and hemorrhagic transformation in moderate to severe ischemic stroke.
作者信息
Rattanawong Wanakorn, Ongphichetmetha Tatchaporn, Hemachudha Thiravat, Thanapornsangsuth Poosanu
机构信息
Department of Medicine, Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand.
Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
出版信息
J Cent Nerv Syst Dis. 2023 Jan 4;15:11795735221147212. doi: 10.1177/11795735221147212. eCollection 2023.
BACKGROUND
Ischemic stroke is a leading cause of morbidity and mortality worldwide. One possible predictor is the use of biomarkers especially neurofilament light chain (NFL).
OBJECTIVES
To explore whether NFL could predict clinical outcome and hemorrhagic transformation in moderate to severe stroke.
DESIGN
Single center prospective cohort study.
METHODS
Fifty-one moderate to severe ischemic stroke patients were recruited. Blood NFL was obtained from patients at admission (First sample) and 24-96 hours later (Second sample). NFL was analyzed with the ultrasensitive single molecule array (Simoa). Later, we calculated incremental rate NFL (IRN) by changes in NFL per day from baseline. We evaluated National Institute of Health stroke scale (NIHSS), modified Rankins score (mRs), and the presence of hemorrhagic transformation (HT).
RESULTS
IRN was found to be higher in patients with unfavorable outcome (7.12 vs 24.07, = .04) as well as Second sample (49.06 vs 71.41, = .011), while NFL First sample was not significant. IRN had a great correlation with mRS (r = .552, < .001). Univariate logistic regression model showed OR of IRN and Second sample to be 1.081 (95% CI 1.016-1.149, = .013) and 1.019 (1.002-1.037, = .03), respectively. Multiple logistic regression model has shown to be significant. In receiver operating analysis, IRN, Second sample, combined IRN with NIHSS and combined Second sample with NIHSS showed AUC (.744, = .004; 0.713, = .01; 0.805, < .001; 0.803, < .001, respectively). For HT, First sample and Second sample had significant difference with HT (Z = 2.13, = .033; Z = 2.487, = .013, respectively).
CONCLUSION
NFL was found to correlate and predict clinical outcome. In addition, it was found to correlate with HT.
背景
缺血性中风是全球发病和死亡的主要原因之一。一种可能的预测指标是生物标志物的使用，尤其是神经丝轻链（NFL）。
目的
探讨NFL是否能预测中度至重度中风的临床结局和出血性转化。
设计
单中心前瞻性队列研究。
方法
招募了51例中度至重度缺血性中风患者。在入院时（第一个样本）和24 - 96小时后（第二个样本）采集患者的血液NFL。使用超灵敏单分子阵列（Simoa）分析NFL。随后，我们通过计算NFL相对于基线每天的变化来计算NFL增量率（IRN）。我们评估了美国国立卫生研究院卒中量表（NIHSS）、改良Rankin量表评分（mRs）以及出血性转化（HT）的存在情况。
结果
发现预后不良患者的IRN更高（7.12对24.07，P = 0.04）以及第二个样本中的IRN更高（49.06对71.41，P = 0.011），而第一个样本的NFL无显著差异。IRN与mRS有很强的相关性（r = 0.552，P < 0.001）。单因素逻辑回归模型显示IRN和第二个样本的OR分别为1.081（95%可信区间1.016 - 1.149，P = 0.013）和1.019（1.002 - 1.037，P = 0.03）。多因素逻辑回归模型显示具有显著性。在受试者工作特征分析中，IRN、第二个样本、IRN与NIHSS联合以及第二个样本与NIHSS联合的曲线下面积分别为（0.744，P = 0.004；0.713，P = 0.01；0.805，P < 0.001；0.803，P < 0.001）。对于HT，第一个样本和第二个样本与HT有显著差异（Z = 2.13，P = 0.033；Z = 2.487，P = 0.013）。
结论
发现NFL与临床结局相关并可预测临床结局。此外，还发现它与HT相关。
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