Stroke:急性缺血性卒中患者合肽素的临床意义

2019-10-22 xing.T MedSci原创

由此可见,急性缺血性脑卒中患者合肽素与脑水肿和出血性转化相关,其在24小时的下降可能反映了有效的脑血管再通。

合肽素在急性缺血性卒中患者中的预后价值已被广泛报道。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,该研究旨在根据血运重建策略以及脑水肿和出血性转化的发展情况来评估合肽素的时态分布。

在入院时(T0)、入院24小时(T1)和住院的第3天至第5天之间(T2),研究人员测量了34名急性缺血性卒中患者血浆中合肽素,以及通过计算机断层扫描/磁共振成像评估了脑水肿及出血性转化。

T0时的合肽素浓度中位数为50.71pmol/L,T1时的合肽素浓度为18.31pmol/L,T2时为10.92pmol/L。在T2时出现中/重度脑水肿的患者中T1时的合肽素水平较高(32.25 vs. 13.67pmol/L; P=0.038),T1(93.10 vs. 13.67pmol/L; P<0.003)和T2(85.70 vs. 14.45)pmol/L;P=0.024)时的出血性转化率较高。在接受血运重建的患者中,尤其是在接受联合治疗的患者中,合肽素水平下降(CopΔT1-T0)程度较急剧(-129.34 vs. -5.43pmol/L;P=0.038)。ΔT1-T0也与脑梗死溶栓评分相关(P<0.001)。

由此可见,急性缺血性脑卒中患者合肽素与脑水肿和出血性转化相关,其在24小时的下降可能反映了有效的脑血管再通。 

原始出处:

Ornella Spagnolell.et al.Copeptin Kinetics in Acute Ischemic Stroke May Differ According to Revascularization Strategies.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.025433

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    2019-10-22 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

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