Lipoprotein(a), Ferritin, and Albumin in Acute Phase Reaction Predicts Severity and Mortality of Acute Ischemic Stroke in North Indian Patients
Lipoprotein(a), Ferritin, and Albumin in Acute Phase Reaction Predicts Severity and Mortality of Acute Ischemic Stroke in North Indian Patients
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DOI：
10.1016/j.jstrokecerebrovasdis.2012.10.013
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发表时间：
2013-10-01
影响因子：
2.5
通讯作者：
Agarwal, Sarita
中科院分区：
文献类型：
--
作者：
Chakraborty, Baidarbhi;Vishnoi, Gaurav;Agarwal, Sarita
背景：炎症在脑卒中的发病机制和预后中起着至关重要的作用。我们研究了脂蛋白（a）[Lp（a）]、铁蛋白和白蛋白作为急性期反应物的行为及其在卒中严重程度和死亡率中的作用。方法：我们招募了100例急性缺血性卒中患者和120例对照组。在第1天和第7天以及第3个月和第6个月采集血样。使用急性卒中治疗分类中的试验10172对卒中进行分类。使用美国国立卫生研究院卒中量表评估卒中严重程度。采用改良兰金量表评估6个月时的预后，采用Kaplan-Meier分析评估死亡率。分别采用酶联免疫吸附试验、免疫比浊法和化学发光试剂盒测定血清白细胞介素-6（IL-6）、脂蛋白（a）、铁蛋白和白蛋白水平。结果：病例组IL-6、Lp（a）和铁蛋白水平始终高于对照组（P < .0001）。血清Lp（a）水平在卒中后第7天达到峰值，此后逐渐下降。入院当天白蛋白水平低于对照组，随后升高。在我们的研究中，Lp（a）作为急性时相反应物，而白蛋白作为负性急性时相反应物。在急性卒中治疗亚型中进行的试验10172与血清Lp（a）、白蛋白和铁蛋白水平升高之间无相关性。重度脑卒中患者Lp（a）和铁蛋白均升高。白蛋白与卒中严重程度呈负相关。血清Lp（a）≥ 77 mg/dL，白蛋白≥ 370 ng/dL与卒中预后不良风险显著增加相关。血清Lp（a）水平>77 mg/dL，白蛋白水平> 77 mg/dL，白蛋白水平> 77 mg/dL
Background: Inflammation plays a crucial role in the pathogenesis and prognosis of stroke. We studied the behavior of lipoprotein(a) [Lp(a)], ferritin, and albumin as acute phase reactants and their roles in the severity and mortality of stroke. Methods: We recruited 100 consecutive patients with acute ischemic stroke and 120 controls. Blood samples were drawn on days 1 and 7 and at both 3 and 6 months. Stroke was classified using Trial of Org 10172 in Acute Stroke Treatment classification. Stroke severity was assessed using the National Institutes of Health Stroke Scale. Prognosis at 6 months was assessed using the modified Rankin Scale, and mortality was assessed using the Kaplan-Meier analysis. Serum levels of interleukin-6 (IL-6), Lp(a), ferritin, and albumin were measured using enzyme-linked immunosorbent assay, immunoturbidimetry, and chemiluminescence commercial kits, respectively. Results: Levels of IL-6, Lp(a), and ferritin were consistently higher among cases than controls (P < .0001). Serum Lp(a) levels peaked at day 7 after stroke and tapered thereafter. Albumin levels were lower than controls on admission day and increased subsequently. In our study, Lp(a) acted as an acute phase reactant while albumin acted as a negative acute phase reactant. There was no association between Trial of Org 10172 in Acute Stroke Treatment subtype and elevated serum levels of Lp(a), albumin, and ferritin. Lp(a) and ferritin were high in patients with severe stroke. Albumin was negatively correlated with stroke severity. Serum levels of Lp(a) >= 77 mg/dL, albumin = 370 ng/dL is associated with a significantly increased risk of having a poorer outcome in stroke. Serum levels of Lp(a) >77 mg/dL and albumin 77 mg/dL and albumin