Stroke:细胞外囊泡表面标记可作为短暂性脑缺血发作的诊断指标

2021-08-04 MedSci原创 MedSci原创

与症状不太可能由脑缺血引起的患者相比,被判定为非常可能由脑缺血引起的短暂症状的患者EV表面抗原谱并不相同。研究人员提出了一种基于EV表面抗原特异性特征的算法,有助于识别TIA。

细胞外囊泡(EV)是脑缺血性疾病有前景的生物标志物,但尚未在短暂性脑缺血发作(TIA)患者中进行系统检验。

近日,血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员旨在(1)调查有疑似TIA患者的EV表面抗原特征;(2)开发和验证基于特定EV表面抗原谱的TIA诊断预测模型。


研究人员分析了来自于训练队列的40名伴有疑似TIA症状的受试者和20名健康对照者。一个由28名受试者组成的独立队列作为外部验证队列。研究人员使用精确诊断评分根据发生真正缺血事件的可能性对患者进行分层,分别为:不太可能(评分0-1)、可能-很可能(评分2-3)或非常可能(评分4-8)。研究人员通过纳米颗粒跟踪分析对血清囊泡进行了定量,并通过多重流式细胞术对EV表面抗原谱进行了表征。


与对照者相比,非常可能或可能-很可能发生TIA的患者EV浓度增加(P<0.05)。纳米颗粒浓度与精确诊断评分直接相关(R=0.712;P<0.001)。EV免疫捕获后,CD8、CD2、CD62P、黑色素瘤相关硫酸软骨素蛋白多糖、CD42a、CD44、CD326、CD142、CD31和CD14被确定为组间判别因子。最后,在训练和外部验证队列中,结合所选标记表达水平的随机森林模型在识别非常可能的TIA患者方面分别具有96%和78.9%的准确率。
 
由此可见,与症状不太可能由脑缺血引起的患者相比,被判定为非常可能由脑缺血引起的短暂症状的患者EV表面抗原谱并不相同。研究人员提出了一种基于EV表面抗原特异性特征的算法,有助于识别TIA。

原始出处:

Jacopo Burrello.et al.Extracellular Vesicle Surface Markers as a Diagnostic Tool in Transient Ischemic Attacks.stroke.2021.https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.033170

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短暂性脑缺血发作——脑卒中的“危险信号”

患者,男性,67岁,因“反复右侧偏身麻木、乏力7h”来院。患者于7h前(当天凌晨5:00左右)在起床过程中出现右侧肢体乏力,可抬离床面,可勉强穿衣,但右上肢不能协调系纽扣、系皮带,右下肢行走拖步。

BMJ:加拿大TIA评分用于短暂性脑缺血发作患者后续中风风险评估

加拿大TIA评分是预测短暂性脑缺血发作患者后续中风风险的有效手段,其有助于急诊医生的早期决策,以改善患者预后

Stroke:女性 vs. 男性的卒中和短暂性脑缺血发作风险差异取决于年龄

与男性相比,女性患卒中或短暂性脑缺血(TIA)发作的风险总体较低。然而,只有40-80岁人群中观察到女性的风险较低。在30岁以下的人群中,女性卒中/TIA风险高于男性。

Aging:替格瑞洛vs氯吡格雷对轻微卒中或 TIA 患者血小板反应性的影响

近日,一项随机对照试验测试了替卡格雷与氯吡格雷对轻微中风或短暂性脑缺血发作(TIA)患者的血小板反应性的影响,研究结果已发表于Aging (Albany NY)。

JAHA:短暂性脑缺血发作和缺血性脑卒中后新发房颤对比

在脑缺血患者中,TIA和轻度卒中之间的区别并没有对随后诊断AF的风险进行分层,这意味着TIA患者应该和缺血性卒中患者一样接受类似的心律监测。