Serum bilirubin levels are associated with poor functional outcomes in patients with acute ischemic stroke or transient ischemic attack.
Serum bilirubin levels are associated with poor functional outcomes in patients with acute ischemic stroke or transient ischemic attack.
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血清胆红素水平与急性缺血性中风或短暂性脑缺血发作患者的功能不良结果相关
DOI：
10.1186/s12883-021-02398-z
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发表时间：
2021-09-27
期刊：
影响因子：
2.6
通讯作者：
Wang Y
中科院分区：
文献类型：
--
作者：
Ouyang Q;Wang A;Tian X;Zuo Y;Liu Z;Xu Q;Meng X;Chen P;Li H;Wang Y
血清胆红素对中风的预后价值存在争议，因为胆红素既有神经保护作用，又有神经毒性作用。本研究旨在探讨血清总胆红素(TBIL)、直接胆红素(DBIL)和间接胆红素(IBIL)与急性缺血性卒中(AIS)和短暂性脑缺血发作(TIA)患者预后不良的关系。所有患者均为第三次中国卒中资料登记中心收治的急性脑梗塞或短暂性脑缺血发作患者。术后3个月和1年的功能结果分别为改良Rankin评分(MRS)2~6分和3~6分。采用多变量Logistic回归分析TBIL、DBIL和IBIL与不良功能结局的关系。在11,121名登记的患者中，总胆红素、DBIL和IBIL的中位数(四分位数范围)分别为13.30(9.90-17.70)，3.80(2.70-5.30)和9.30(6.70-12.80)µmol/L。调整传统混杂因素后，在3个月(优势比[OR]，1.37；95 %可信区间[CI]，1.19-1.59)和一年(OR，1.31)中，总胆红素水平最高的患者MRS评分2-6分的比例最高；3个月(OR，1.33；95 %CI，1.11~1.59)和1年(OR，1.28；95 %CI，1.07~1.53)的MRS评分3~6分。DBIL和IBIL也观察到类似的结果。我们还发现血清胆红素水平和每种结局之间存在J型关联。血清胆红素水平升高与AIS或TIA患者在3个月和1年的功能预后不良显著相关。网上版载有补充材料，可在10.1186/s12883-021-02398-z查阅。
The prognostic value of serum bilirubin in stroke is controversial, since bilirubin has both neuroprotective and neurotoxic properties. We aimed to investigate the association between serum bilirubin, including total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) and poor functional outcomes in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA). All patients with AIS or TIA were recruited from the Third China National Stroke Registry. The poor functional outcomes included modified Rankin Scale (mRS) score 2–6 and 3–6 at 3 months and 1 year. Multivariable logistic regression was used to investigate the associations of TBIL, DBIL, and IBIL with poor functional outcomes. Among 11,121 enrolled patients, the median (interquartile range) of TBIL, DBIL, and IBIL was 13.30 (9.90–17.70), 3.80 (2.70–5.30), and 9.30 (6.70–12.80) µmol/L. After adjustment for conventional confounding factors, patients in the highest TBIL quartile had the highest proportion of mRS score 2–6 at 3 months (odds ratio [OR], 1.37; 95 % confidence interval [CI], 1.19–1.59) and 1 year (OR, 1.31; 95 % CI, 1.13–1.52), and mRS score 3–6 at 3 months (OR, 1.33; 95 % CI, 1.11–1.59) and 1 year (OR, 1.28; 95 % CI, 1.07–1.53), when compared to patients in the lowest TBIL quartile. Similar results were observed for DBIL and IBIL. We also found J-shaped associations between serum bilirubin levels and each outcome. Elevated levels of serum bilirubin were significantly associated with poor functional outcomes in patients with AIS or TIA at 3 months and 1 year. The online version contains supplementary material available at 10.1186/s12883-021-02398-z.
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影响因子：
3.5
作者：
Durante, W
通讯作者：
Durante, W
急性缺血性中风后胆红素升高与中风严重程度相关
DOI：
10.1016/j.ijdevneu.2013.08.002
发表时间：
2013-11-01
影响因子：
1.8
作者：
Luo, Yun;Li, Jingwei;Xu, Yun
通讯作者：
Xu, Yun
DOI：
10.1016/j.jstrokecerebrovasdis.2008.01.009
发表时间：
2008-05-01
期刊：
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
影响因子：
--
作者：
Pineda, Sandra;Bang, Oh Young;Ovbiagele, Bruce
通讯作者：
Ovbiagele, Bruce
影响因子：
9.9
作者：
Adams, HP;Davis, PH;Hansen, MD
通讯作者：
Hansen, MD
影响因子：
5.7
作者：
Rodrigues, CMP;Solá, S;Brites, D
通讯作者：
Brites, D