Neurology:颈动脉支架置入后三甲胺N-氧化物升高与缺血性脑损伤有关!

2018-03-15 xing.T MedSci原创

由此可见,TMAO水平升高与CAS后MRI扫描中新发缺血性脑损伤风险增加有关。

近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,研究人员旨在评估血浆中三甲胺N-氧化物(TMAO),一种动脉粥样硬化性肠道微生物代谢产物,可作为继发于颈动脉支架术(CAS)的缺血性脑损伤的预测指标。

在这项多中心、前瞻性队列研究中,研究人员招募了准备进行CAS的严重颈动脉狭窄(>70%)的患者。在CAS操作前3天内测量血浆TMAO水平,并在CAS后1至3天进行MRI检查。

在268例符合纳入标准的患者中,平均年龄为64.4岁。117例患者(43.7%)通过弥散加权成像(DWI)检出新病灶。具有新发(DWI)病灶的患者TMAO水平高于无新病变患者(中位数为5.2 vs. 3.2μmol/L; P<0.001)。血浆TMAO水平升高与CAS后发生DWI新病灶的风险增加有关(最高与最低四分位数相比校正后的比值比为3.85; 95%可信区间为1.37-7.56,P<0.001;第三个 vs. 最低四分位数校正后的比值比为1.86; 95%可信区间为1.09-4.66,P=0.02)。 TMAO预测DWI新病灶的受试者工作特征曲线下面积为0.706,最佳截断值为4.29μmol/L。 TMAO≥4.29μmol/L预测DWI新病灶的敏感性、特异性、阳性预测值和阴性预测值分别为61.5%、74.8%、65.5%和65.5%。

由此可见,TMAO水平升高与CAS后MRI扫描中新发缺血性脑损伤风险增加有关。

原始出处:

Chuanjie Wu, Elevated trimethylamine N-oxide related to ischemic brain lesions after carotid artery stenting.neurology.2018.https://doi.org/10.1212/WNL.0000000000005298

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    2018-09-11 yinhl1978
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    2018-03-17 陈吴1239
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    2018-03-16 changjiu

    学习一下谢谢

    0

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