Kraljević Ivan, Marinović Guić Maja, Budimir Mršić Danijela, Dolić Krešimir, Čaljkušić Krešimir, Benzon Benjamin, Šupe Domić Daniela, Lovrić Kojundžić Sanja
Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia.
Department of Diagnostic and Interventional Radiology, School of Medicine, University of Split, 21000 Split, Croatia.
Life (Basel). 2025 Mar 18;15(3):495. doi: 10.3390/life15030495.
As acute ischemic stroke (AIS) is still a significant cause of morbidity globally, new methods of rapid diagnostics are continually being researched and improved. Still, the only definite way to diagnose AIS is radiological imaging. Lately, serum biomarkers glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have shown their usefulness in AIS as potential complementary tools in early recognition. We aimed to investigate if GFAP and UCH-L1 can correlate with comprehensive diagnostic information provided by computed tomography (CT) and several clinical parameters in AIS severity assessment and subsequently with clinical outcomes. Fifty-two patients with AIS and a potential for mechanical thrombectomy (MT) were included in our study. Thirty-seven patients underwent MT. Results showed no correlation of biomarkers with any analyzed CT parameter (thrombus length, volume, and density, clot burden score, collateral score, AIS core and penumbra volume, differences in perfusion between healthy and affected brain tissue). In addition, none of the clinical parameters, such as sex, symptom onset time, or the National Institutes of Health Stroke Scale, correlated with biomarkers. However, lower biomarker levels corresponded with a good clinical outcome, and higher levels to a poor outcome following hospital discharge, irrespective of the performed MT ( = 0.005 for GFAP, = 0.001 for UCH-L1). In patients with successful MT, there were also differences between patients with a good clinical outcome compared with patients with a poor clinical outcome ( = 0.007 for GFAP, = 0.004 for UCH-L1). In conclusion, these biomarkers cannot replace imaging modalities but can provide complementary diagnostic information in the setting of AIS.
由于急性缺血性卒中（AIS）仍是全球发病的一个重要原因，快速诊断的新方法一直在不断研究和改进。尽管如此，诊断AIS的唯一明确方法仍是放射影像学检查。最近，血清生物标志物胶质纤维酸性蛋白（GFAP）和泛素C末端水解酶L1（UCH-L1）已显示出在AIS中作为早期识别潜在补充工具的作用。我们旨在研究GFAP和UCH-L1是否能与计算机断层扫描（CT）提供的综合诊断信息以及AIS严重程度评估中的几个临床参数相关，并随后与临床结局相关。我们的研究纳入了52例有机械取栓（MT）可能性的AIS患者。37例患者接受了MT。结果显示，生物标志物与任何分析的CT参数（血栓长度、体积和密度、血栓负荷评分、侧支循环评分、AIS核心区和半暗带体积、健康脑组织与患侧脑组织灌注差异）均无相关性。此外，性别、症状发作时间或美国国立卫生研究院卒中量表等临床参数均与生物标志物无相关性。然而，无论是否进行MT，生物标志物水平较低与良好的临床结局相关，而较高水平则与出院后不良结局相关（GFAP为P = 0.005，UCH-L1为P = 0.001）。在MT成功的患者中，临床结局良好的患者与临床结局不良的患者之间也存在差异（GFAP为P = 0.007，UCH-L1为P = 0.004）。总之，这些生物标志物不能替代影像学检查，但可以在AIS情况下提供补充诊断信息。
