A Preliminary Cohort Study Assessing Routine Blood Analyte Levels and Neurological Outcome after Spinal Cord Injury
A Preliminary Cohort Study Assessing Routine Blood Analyte Levels and Neurological Outcome after Spinal Cord Injury
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DOI：
10.1089/neu.2019.6495
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发表时间：
2019-08-06
影响因子：
4.2
通讯作者：
Wright, Karina T.
中科院分区：
文献类型：
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作者：
Brown, Sharon J.;Harrington, Gabriel M. B.;Wright, Karina T.
人们对鉴定能够预测脊髓损伤（SCI）后神经预后的生物标志物越来越感兴趣。尽管最初的美国脊髓损伤协会（ASIA）损伤量表（AIS）分级是神经系统预后的良好指标，但对于患者和临床医生来说，仍存在不确定性因素。本初步研究旨在评估主成分分析（PCA）后常规血液分析的附加潜力，以建立脊髓损伤后神经预后模型。收集脊髓损伤患者（n = 82）的血常规及临床资料，采用PCA将血液分析物的数量减少为相关因素。通过损伤后3个月和12个月的AIS评分获得神经学结果，分别评估运动（AIS和包括所有肌组在内的总AIS）和感觉（AIS、触觉和疼痛）能力。对所有结果测量建立多元回归模型。发现与“肝功能”和“急性炎症和肝功能”因素相关的血液分析可显著提高3个月（触觉、疼痛和AIS感觉）和1年（疼痛R-2增加0.025，总运动R-2增加0.016）时神经预后的预测。部分模型的“肝功能”和“急性炎症及肝功能”因素均具有显著预测性，3个月疼痛预测R-2综合改善最大，为0.043。这些初步发现支持正在进行的使用常规血液分析预测脊髓损伤患者神经预后的研究。
There is increasing interest in the identification of biomarkers that could predict neurological outcome following a spinal cord injury (SCI). Although initial American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade is a good indicator of neurological outcome, for the patient and clinicians, an element of uncertainty remains. This preliminary study aimed to assess the additive potential of routine blood analytes following principal component analysis (PCA) to develop prognostic models for neurological outcome following SCI. Routine blood and clinical data were collected from SCI patients (n = 82) and PCA used to reduce the number of blood analytes into related factors. Outcome neurology was obtained from AIS scores at 3 and 12 months post-injury, with motor (AIS and total including all myotomes) and sensory (AIS, touch and pain) abilities being assessed individually. Multiple regression models were created for all outcome measures. Blood analytes relating to "liver function" and "acute inflammation and liver function" factors were found to significantly increase prediction of neurological outcome at both 3 months (touch, pain, and AIS sensory) and at 1 year (pain, R-2 increased by 0.025 and total motor, R-2 increased by 0.016). For some models "liver function" and "acute inflammation and liver function" factors were both significantly predictive, with the greatest combined R-2 improvement of 0.043 occurring for 3 month pain prediction. These preliminary findings support ongoing research into the use of routine blood analytes in the prediction of neurological outcome in SCI patients.