Dynamic changes in the glycocalyx and clinical outcomes in patients undergoing endovascular treatments for large vessel occlusion.
Dynamic changes in the glycocalyx and clinical outcomes in patients undergoing endovascular treatments for large vessel occlusion.
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DOI：
10.3389/fneur.2023.1046915
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发表时间：
2023
影响因子：
3.4
通讯作者：
中科院分区：
文献类型：
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作者：
我们旨在验证糖萼作为接受血管内治疗的急性缺血性卒中患者血脑屏障损伤标志物的预后价值。我们招募了正在接受再通的大血管闭塞患者，并在多个时间点检测了他们的糖萼。根据90天的随访数据，将患者分为存活组和非存活组。此外，还对神经功能进行了跟踪，并将患者分为神经功能恶化组和无神经功能恶化组。使用线性混合模型确定结果与糖萼动态变化之间的相关性，并将显著因素用作协变量。失活者和神经功能恶化患者的syndecan-1浓度显著高于存活者和无神经功能恶化患者，并且syndecan-1在血管内治疗后趋于下降（p < 0.05）。血管内治疗后36 h多配体蛋白聚糖-1水平的增加与美国国立卫生研究院卒中量表神经功能恶化评分呈正相关（r = 0.702，p = 0.005）。然而，不同临床结局患者血浆中透明质酸或硫酸乙酰肝素水平无显著差异。大血管闭塞性卒中患者再灌注前syndecan-1水平与90天死亡率相关，syndecan-1的再降解与神经功能恶化呈正相关。
We aimed to verify the prognostic value of the glycocalyx as a marker of blood–brain barrier damage in patients with acute ischemic stroke undergoing endovascular therapy. We recruited patients with large vessel occlusion who were undergoing recanalization and tested their glycocalyx at multiple time points. On the basis of the 90-day follow-up data, the patients were divided into a survivor group and a nonsurvivor group. In addition, neurological function was tracked, and patients were divided into a neurological deterioration group and a group without neurological deterioration. Associations between outcomes and dynamic changes in the glycocalyx were determined using a linear mixed model, and significant factors were used as covariates. Nonsurvivors and patients with neurological deterioration had significantly higher syndecan-1 concentrations than survivors and patients without neurological deterioration, and syndecan-1 tended to decline after endovascular therapy (p < 0.05). The increased level of syndecan-1 at 36 h after endovascular treatment was positively correlated with the National Institute of Health Stroke Scale score for neurological deterioration (r = 0.702, p = 0.005). However, there was no significant difference in the level of hyaluronic acid or heparan sulfate in the plasma of patients with different clinical outcomes. Pre-reperfusion syndecan-1 levels in patients with large vessel occlusion stroke are associated with 90-day mortality and the re-degradation of syndecan-1 is positively associated with neurological deterioration.
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