Leukocyte activation: Relation to cardiovascular mortality after cerebrovascular ischemia
Leukocyte activation: Relation to cardiovascular mortality after cerebrovascular ischemia
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DOI：
10.1159/000016037
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发表时间：
2000-03-01
影响因子：
2.9
通讯作者：
Ohlsson, K
中科院分区：
文献类型：
--
作者：
Falke, P;Elneihoum, AM;Ohlsson, K
活化的白细胞被认为与动脉粥样硬化性血管疾病的发生、发展及其后果有关。采用酶联免疫吸附试验检测144例患者(90例卒中，54例短暂性脑缺血发作)脑缺血后1~3天的血浆可溶性肿瘤坏死因子受体蛋白-1(sTNFR-1)、中性粒细胞明胶酶相关脂结合蛋白(NGAL)和中性粒细胞蛋白酶-4(NP4)水平。在4年的随访中，144名患者中有42人(29%)死亡，38人死于心血管疾病，4人死于其他原因。有较高白细胞激活证据的患者(n=47)比无白细胞激活证据的患者(n=97；p<；0.005)的4年心血管死亡率更高。以年龄、性别和其他有意义的预测因素为协变量的Logistic回归分析显示，血浆sTNFR1和NGAL水平均是心血管死亡的显著独立预测因素，其优势比和95%可信区间分别为2.0、1.2~3.4和3.6、1.2~10.5，p=0.02。我们的结论是，在急性脑缺血患者中，白细胞激活的血浆标志物是长期心血管死亡的重要预测因素。这可能表明激活的白细胞在这些疾病的进展中起着重要作用。版权所有(C)2000 S.Karger AG，巴塞尔。
Activated leukocytes are believed to be involved in the pathogenesis and progression of atherosclerotic vascular disease and its consequences. In a 4-year observational follow-up study, we investigated whether markers for systemic leukocyte activation (leukocyte-derived inflammatory mediators) were related to cardiovascular mortality after cerebrovascular ischemia, Using enzyme-linked immunosorbent assays, we measured the plasma levels of soluble tumor necrosis factor receptor protein-1 (sTNFR-1), neutrophil gelatinase-associated lipocalin (NGAL) and neutrophil protease-4 (NP4) in 144 patients (90 stroke, 54 transient ischemic attack) 1-3 days after cerebral ischemia. During the 4 years of follow-up, 42 (29%) of the 144 patients died; 38 of cardiovascular causes and 4 of other causes. Patients with evidence of higher leukocyte activation (n = 47) had a higher 4-year cardiovascular mortality rate than those without evidence of leukocyte activation (n = 97; p < 0.005). Logistic regression analysis with age, sex and other significant predictors as covariates showed higher plasma levels of sTNFR1 and NGAL both to be significant independent predictors of cardiovascular mortality, the respective odds ratio, 95% confidence intervals, and p values being 2.0, 1.2-3.4, p < 0.01, and 3.6, 1.2-10.5, p = 0.02, respectively. We concluded that in patients with acute cerebral ischemia, plasma markers of leukocyte activation were significant predictors of long-term cardiovascular mortality. This may indicate an important role of activated leukocytes in the progression of these diseases. Copyright (C) 2000 S. Karger AG, Basel.