High-sensitivity C-reactive protein, lipoprotein-related phospholipase A2, and acute ischemic stroke.
High-sensitivity C-reactive protein, lipoprotein-related phospholipase A2, and acute ischemic stroke.
复制标题
DOI：
10.2147/ndt.s67665
复制
发表时间：
2014
影响因子：
3.2
通讯作者：
Sivri M
中科院分区：
文献类型：
--
作者：
Kara H;Akinci M;Degirmenci S;Bayir A;Ak A;Nayman A;Unlu A;Akyurek F;Sivri M
血清生物标志物可能有助于急性缺血性卒中的早期诊断，排除其他可能模拟卒中的疾病，以及预测梗死体积。我们评估了急性缺血性卒中患者血清高敏c反应蛋白（hs-CRP）和脂蛋白相关磷脂酶A2 （Lp-PLA2）。在200例急诊患者中（急性缺血性卒中102例，对照组无卒中98例），卒中患者用加拿大神经学量表和弥散加权磁共振成像进行评估，所有患者用格拉斯哥昏迷量表进行评估，并评估其血清hs-CRP水平和Lp-PLA2活性。脑卒中病变的体积由磁共振图像计算。脑卒中患者血清hs-CRP水平（脑卒中，7±6 mg/dL；对照组，平均±标准差1±1 mg/dL； P≤0.001）和Lp-PLA2活性（脑卒中，平均±标准差113±86 nmol/min/mL；对照组，平均±标准差103±50 nmol/min/mL； P≤0.001）均高于无脑卒中患者。中风严重程度越高（加拿大神经学量表评分越低）的患者hs-CRP水平和Lp-PLA2活性越高，卒中容量越大的患者hs-CRP水平和Lp-PLA2活性越高。在急性缺血性卒中患者中，较高的hs-CRP水平和Lp-PLA2活性与更严重的神经功能损害和更大的梗死面积显著相关。这些生物标志物可能有助于快速诊断和预测缺血性脑卒中早期的缺血组织体积。这些发现可能对医疗机构来说很重要，因为这些医疗机构在诊断中风时只能通过紧急计算机断层扫描进行诊断。
Serum biomarkers may be useful for early diagnosis of acute ischemic stroke, exclusion of other diseases that may mimic stroke, and prediction of infarct volume. We evaluated serum high-sensitivity C-reactive protein (hs-CRP) and lipoprotein-related phospholipase A2 (Lp-PLA2) in patients who had acute ischemic stroke. In 200 patients who presented to an emergency service (acute ischemic stroke, 102 patients; control with no stroke, 98 patients), stroke patients were evaluated with the Canadian neurological scale and diffusion-weighted magnetic resonance imaging, and all patients were evaluated with the Glasgow coma scale and their serum hs-CRP level and Lp-PLA2 activity were assessed. The volume of stroke lesions was calculated from magnetic resonance images. Patients who had stroke had higher mean serum hs-CRP level (stroke, 7±6 mg/dL; control, mean ± standard deviation 1±1 mg/dL; P≤0.001) and Lp-PLA2 activity (stroke, mean ± standard deviation 113±86 nmol/min/mL; control, mean ± standard deviation 103±50 nmol/min/mL; P≤0.001) than control patients who did not have stroke. The mean hs-CRP level and Lp-PLA2 activity were higher in patients who had greater stroke severity (lower Canadian neurological scale score) and were higher in patients who had larger volume strokes. Higher hs-CRP level and Lp-PLA2 activity are significantly associated with more severe neurologic impairment and larger infarct size in patients who have acute ischemic stroke. These biomarkers may be useful for rapid diagnosis and prediction of ischemic tissue volume in the early stage of ischemic stroke. These findings may be important for health care facilities that have limited access to emergency computed tomography scanning for the diagnosis of stroke.