Peng Min, Sun Xiaoyun, Yuan Xiangling, Tao Chenjuan, Xu Gelin
Department of Neurology, Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
Department of Neurology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
Front Neurol. 2025 Mar 31;16:1533933. doi: 10.3389/fneur.2025.1533933. eCollection 2025.
Although fecal occult hemoglobin is commonly valued as a screening tool for colorectal cancer, few studies have examined the clinical significance of fecal immunochemical testing (FIT) in other diseases. This study aimed to explore the association between occult blood in feces and functional outcomes of acute ischemic stroke (AIS) patients who received intravenous thrombolysis treatment.
Patients diagnosed with acute ischemic stroke and received thrombolytic therapy were recruited from the neurology department of the Affiliated Hospital of Hangzhou Normal University. FIT was conducted for patients during hospitalization. Functional outcome was assessed by the modified Rankin Scale (mRS). A favorable outcome was defined as mRS 0-2 and a poor outcome as mRS 3-6.
A total of 214 patients were included for analysis. The proportion of FIT-positive patients was higher in the poor outcome group than in the favorable group (12.3% vs. 45.6%, < 0.001). Logistic regression models showed that FIT-positive patients had an increased risk of a poor outcome (OR: 4.188, 95% CI: 1.424-11.51, = 0.005) after adjusting for possible variables. Moreover, in addition to gastrointestinal bleeding, NIHSS score at baseline (OR: 1.092, 95% CI: 1.013-1.176, = 0.021) and white blood cell level (OR: 1.215, 95% CI: 1.018-1.448, = 0.031) were also the independent risk factors for positive FIT after thrombolytic therapy in AIS.
Positive FIT was related to the poor outcomes in AIS patients who received thrombolytic therapy. High NIHSS scores at baseline and high white blood cell levels were the risks of FIT.
尽管粪便潜血血红蛋白通常被视为结直肠癌的筛查工具，但很少有研究探讨粪便免疫化学检测（FIT）在其他疾病中的临床意义。本研究旨在探讨接受静脉溶栓治疗的急性缺血性卒中（AIS）患者粪便潜血与功能结局之间的关联。
从杭州师范大学附属医院神经内科招募诊断为急性缺血性卒中并接受溶栓治疗的患者。患者在住院期间进行FIT检测。功能结局采用改良Rankin量表（mRS）进行评估。良好结局定义为mRS 0-2，不良结局定义为mRS 3-6。
共纳入214例患者进行分析。不良结局组FIT阳性患者的比例高于良好结局组（12.3%对45.6%，<0.001）。逻辑回归模型显示，在调整可能的变量后，FIT阳性患者出现不良结局的风险增加（OR：4.188，95%CI：1.424-11.51，=0.005）。此外，除胃肠道出血外，基线时的美国国立卫生研究院卒中量表（NIHSS）评分（OR：1.092，95%CI：1.013-1.176，=0.021）和白细胞水平（OR：1.215，95%CI：1.018-1.448，=0.031）也是AIS溶栓治疗后FIT阳性的独立危险因素。
FIT阳性与接受溶栓治疗的AIS患者的不良结局相关。基线时高NIHSS评分和高白细胞水平是FIT的危险因素。
