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以神经球蛋白为标志物的缺血性卒中六个月时的预后

Outcome of Ischemic Stroke at Six Months with Neuroglobin as a Marker.

作者信息

Ramli Yetty, Rusdi Fadhlan, Kurniawan Mohammad, Sadikin Mohamad, Evelyn Florencia

机构信息

Drs. Ramli, Rusdi, Kurniawan, and Evelyn are with the Department of Neurology, Faculty of Medicine, Universitas Indonesia in Jakarta, Indonesia.

Dr. Sadikin is with the Department of Biochemistry and Molecular Biology, Faculty of Medicine, Universitas Indonesia in Jakarta, Indonesia.

出版信息

Innov Clin Neurosci. 2024 Dec 1;21(10):38-43. eCollection 2024 Oct-Dec.

Abstract

Prognostic markers can optimize the management of acute ischemic stroke (AIS). Neuroglobin (Ngb), which plays a role in intraneuronal oxygen transport and hypoxia resistance, is a potential prognostic marker in AIS. A cohort study was conducted on patients with AIS treated at Dr. Cipto Mangunkusumo National Referral Hospital from March to April 2023. Serum samples for Ngb examination were collected three days after the onset of the stroke, while a modified Rankin Scale (mRS) was obtained after seven days and again after six months. National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI), and Montreal Cognitive Assessment (MoCA-Ina) scores were obtained on the seventh day. Significance analysis and receiver operating characteristic (ROC) curve were used to determine the relationship between Ngb and AIS outcomes. A total of 42 subjects underwent analysis. Serum Ngb levels were higher in subjects with mRS score of 3 to 6, compared to those with scores of 0 to 2 (median [range]: 12.42ng/mL [3.57-50.43] vs. 4.79ng/mL [2.25-37.32], =0.005). The association with mRS persisted until six months post-AIS (=0.004). The area under the ROC curve (AUC) was 0.75. Ngb levels were also higher in groups with higher NIHSS at discharge (=0.03), lower BI (=0.01), and lower MoCA-Ina scores (=0.002). Clinical assessments (BI and NIHSS), along with evaluations of cognitive function and Ngb markers, can be employed to monitor patient progress and predict stroke outcomes up to six-months post-AIS. Higher serum Ngb levels in AIS are associated with poorer functional outcomes. Further research is needed before clinical application.

摘要

预后标志物可以优化急性缺血性卒中(AIS)的管理。神经球蛋白(Ngb)在神经元内氧气运输和抗缺氧中发挥作用,是AIS中一种潜在的预后标志物。对2023年3月至4月在西托·曼贡库苏莫国家转诊医院接受治疗的AIS患者进行了一项队列研究。在卒中发作三天后采集用于检测Ngb的血清样本,而改良Rankin量表(mRS)评分在七天后以及六个月后再次获取。在第七天获取美国国立卫生研究院卒中量表(NIHSS)、巴氏指数(BI)和蒙特利尔认知评估(MoCA-Ina)评分。采用显著性分析和受试者工作特征(ROC)曲线来确定Ngb与AIS预后之间的关系。共有42名受试者接受分析。mRS评分为3至6分的受试者血清Ngb水平高于评分为0至2分的受试者(中位数[范围]:12.42ng/mL[3.57 - 50.43] vs.

4.79ng/mL[2.25 - 37.32],P = 0.005)。与mRS的关联在AIS后六个月仍然存在(P = 0.004)。ROC曲线下面积(AUC)为0.75。出院时NIHSS评分较高(P = 0.03)、BI较低(P = 0.01)以及MoCA-Ina评分较低(P = 0.002)的组中Ngb水平也较高。临床评估(BI和NIHSS)以及认知功能和Ngb标志物评估可用于监测患者进展并预测AIS后长达六个月的卒中预后。AIS患者血清Ngb水平较高与较差的功能预后相关。在临床应用之前还需要进一步研究。

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