Prognostic use of circulating plasma nucleic acid concentrations in patients with acute stroke
Prognostic use of circulating plasma nucleic acid concentrations in patients with acute stroke
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DOI：
10.1373/49.4.562
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发表时间：
2003-04-01
影响因子：
9.3
通讯作者：
Lo, YMD
中科院分区：
文献类型：
--
作者：
Rainer, TH;Wong, LKS;Lo, YMD
工作背景：目前，没有简单，准确的血液测试，可用于确定中风的严重程度或预测死亡率和发病率在中风患者提出的急诊departments.Methods：中风样症状的患者谁提出的一个大学医院在香港的急诊科被招募的研究。从患者血浆中提取的DNA用基于荧光的PCR测试分析β-珠蛋白基因。主要结果的措施是在医院和6个月的死亡率和发病率使用中风后修改兰金Score.Results：在88例连续招募到研究中，70（80%）缺血性中风，11（13%）脑出血，7（8%）有短暂性脑缺血发作。在症状发作后3小时内采集的中位血浆DNA浓度，死亡患者高于出院时存活的患者（6205 vs 1334 kD/L; P = 0.03）。在NIH卒中量表评分>8分的患者中，死亡患者的血浆DNA浓度中位数高于存活6个月的患者（2273 vs 968 kD/L; P = 0.002）。血浆DNA浓度与脑血肿体积呈正相关（r = 0.66; P = 0.03）。血浆DNA浓度>1400 kD/L预测卒中后住院死亡率的敏感性为100%，特异性为74.4%，ROC曲线下面积为0.89（95%置信区间为0.80-0.94）。血浆DNA浓度预测6个月死亡率的校正比值比为1.6（1.1-2.4; P = 0.03），预测6个月后Rankin评分>2的校正比值比为1.8（1.0-3.3; P = 0.05）。结论：血浆DNA浓度与卒中严重程度相关，可用于预测急诊室的死亡率和发病率。(C)2003年美国临床化学协会。
Background: At present there is no simple, accurate blood test that may be used to determine the severity of stroke or to predict mortality and morbidity in stroke patients presenting to emergency departments.Methods: Patients with stroke-like symptoms who presented to an emergency department of a university hospital in Hong Kong were recruited for the study. DNA extracted from patients' plasma was analyzed for the beta-globin gene with a fluorescent-based PCR test. The primary outcome measures were in-hospital and 6-month mortality and morbidity using the post-stroke modified Rankin Score.Results: Among the 88 consecutive patients recruited to the study, 70 (80%) had ischemic stroke, 11 (13%) had intracerebral hemorrhage, and 7 (8%) had transient ischemic attacks. Median plasma DNA concentrations taken within 3 h of symptom onset were higher in patients who died compared with those who survived at discharge (6205 vs 1334 kilogenome-equivalents/L; P = 0.03). Among patients with NIH Stroke Scale scores >8, median plasma DNA concentrations were higher in patients who died compared with those who survived to 6 months (2273 vs 968 kilogenome-equivalents/L; P = 0.002). Plasma DNA concentrations correlated with the volume of cerebral hematoma (r = 0.66; P = 0.03). Plasma DNA concentrations >1400 kilogenome-equivalents/L had a sensitivity of 100% and a specificity of 74.4% for predicting hospital mortality after stroke, and the area under the ROC curve was 0.89 (95% confidence interval, 0.80-0.94). The adjusted odds ratio for plasma DNA concentrations predicting 6-month mortality was 1.6 (1.1-2.4; P = 0.03) and for predicting 6-month post-Rankin Score >2 was 1.8 (1.0-3.3; P = 0.05).Conclusion: Plasma DNA concentrations correlate with stroke severity and may be used to predict mortality and morbidity in the emergency room. (C) 2003 American Association for Clinical Chemistry.