Elevated bilirubin after acute ischemic stroke linked to the stroke severity
Elevated bilirubin after acute ischemic stroke linked to the stroke severity
复制标题
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
复制
发表时间：
2013-11-01
影响因子：
1.8
通讯作者：
Xu, Yun
中科院分区：
文献类型：
--
作者：
Luo, Yun;Li, Jingwei;Xu, Yun
背景资料：本课题组前期研究表明，急性缺血性脑卒中（AIS）后血清胆红素水平与脑卒中的严重程度相关，并且有证据表明AIS患者普遍存在高胆红素血症。方法：对608例AIS患者和188例短暂性脑缺血发作（TIA）患者进行胆红素等生化指标的检测，并与对照组进行比较。在采血的同时评估美国国立卫生研究院卒中量表（NIHSS）评分。首先，比较AIS组和对照组的胆红素水平及其分布。根据截断点分析胆红素升高的影响因素，包括直接胆红素（Dbil）和总胆红素（Tbil），特别是胆红素升高与脑卒中严重程度的相关性。结果：AIS组血清Dbil、Tbil水平明显高于TIA组，差异有统计学意义（P < 0. 05）。AIS组与TIA组的分布不同，低胆红素组低于TIA组，高胆红素组高于TIA组，Dbil和Tbil的p值分别为0.043和0.078。当胆红素升高的临界点选择为Dbil ≥ 6.84 μ mol/L和Tbil ≥ 22.2 μ mol/L时，我们发现无论是Dbil还是Tbil，NIHSS评分和AIS的相对严重程度都与胆红素升高显著相关，OCSP亚型也是如此。多因素Logistic回归分析校正相关影响因素后仍维持这一趋势。结论：AIS后血清Dbil、Tbil水平升高，与脑卒中严重程度相关。(C)2013由Elsevier Ltd代表ISDN出版。
Background: Our previous study demonstrated that the level of serum bilirubin after acute ischemic stroke (AIS) was correlated to the severity of stroke, also there has the evidence of hyperbilirubinemia prevalent in AIS. We aimed to identify the exact change of bilirubin in the early phase of AIS, and study if this kind of change linked to the severity of stroke.Methods: Bilirubin and other biochemical indexes were measured in 608 AIS patients and 188 transient ischemic attack (TIA) patients which set as the control group. National Institutes of Health Stroke Scale (NIHSS) scores were assessed simultaneously with blood collection. First, the level of bilirubin and its distribution were compared between the AIS and control group. According to a cut-off point, we next analyzed the impacted factors of elevated bilirubin including the direct bilirubin (Dbil) and total bilirubin (Tbil), especially the correlation between elevated bilirubin and the severity of stroke. Finally, we compared the difference of concentration and percent of elevated bilirubin among the Oxford Community Stroke Project (OCSP) subtypes.Results: The level of serum Dbil and Tbil was significantly higher in the AIS group than that in the TIA group. Different distribution was observed between the two groups, which manifested as the percent of low bilirubin level group was lower while high level group was higher in AIS than that in TIA, the p value were 0.043 and 0.078 in Dbil and Tbil, respectively. When the cut-off point of elevated bilirubin was selected as Dbil >= 6.84 mu mol/L and Tbil >= 22.2 mu mol/L, we found that both NIHSS score and relative severity of AIS were significantly associated with elevated bilirubin whenever in Dbil or Tbil, so did the OCSP subtypes. This trend was still maintained by multivariable logistic regression analysis adjust for relative influence factors. In regard of OCSP subtypes, the highest level of bilirubin was found in TACI, so did the highest rate of elevated bilirubin.Conclusion: The serum levels of Dbil and Tbil were increased after AIS, which linked to the severity of stroke. (C) 2013 Published by Elsevier Ltd on behalf of ISDN.