胶质纤维酸性蛋白是接受血管内血栓切除术的急性缺血性患者出现症状性颅内出血的潜在指标

IF 3.6 3区医学

Clinical Interventions in Aging Pub Date : 2024-01-22 DOI:10.2147/cia.s448180

Minghao Li, Hua Liu, Mingyang Xu, Baiyang Yu, Minwang Guo, Xiaorong Wang, Guomei Shi, Rujuan Zhou

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引用次数: 0

摘要

背景：在接受血管内血栓切除术（EVT）治疗的急性缺血性卒中（AIS）患者中，神经胶质纤维酸性蛋白（GFAP）与症状性颅内出血（sICH）之间的相关性仍不确定。我们旨在评估血液中GFAP水平与sICH发生之间的关联：方法：回顾性纳入2019年6月至2023年5月期间在卒中中心接受EVT治疗的142例连续AIS患者和体检中心的35例对照组。在血管内治疗前（T1）和术后24小时（T2），使用酶联免疫吸附试验对血液中的GFAP水平进行量化。根据海德堡出血分类法确定 sICH：AIS患者T1时的血清GFAP水平明显高于对照组（0.249 [0.150- 0.576] 对 0.065 [0.041- 0.110] ng/mL，p = 0.001），T2时的GFAP水平明显高于T1时（3.813 [1.474, 5.876] 对 0.249 [0.150- 0.576] ng/mL，p = 0.001）。在142名AIS患者中，18人（14.5%）在EVT后发生了sICH。在未调整模型（OR 1.513，95% CI 1.269-1.805，p = 0.001）和多变量调整模型（OR 1.518，95% CI 1.153-2.000，p = 0.003）中，T2 期血清 GFAP 水平与 sICH 有显著相关性。此外，在传统模型中加入 T2 期的 GFAP 可显著提高 sICH 的风险再分类（综合分辨力提高 [IDI] 0.183，95% CI 0.070- 0.295，p = 0.001）：结论：EVT 24 小时后，AIS 患者血清 GFAP 水平明显升高。结论：EVT 24 小时后，AIS 患者血清 GFAP 水平显著升高，GFAP 水平升高与 sICH 风险升高相关。GFAP 有可能成为接受 EVT 治疗的 AIS 患者发生 sICH 的可靠指标。

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Glial Fibrillary Acidic Protein as a Potential Indicator for Symptomatic Intracranial Hemorrhage in Acute Ischemic Patients Undergoing Endovascular Thrombectomy

Background: The correlation between glial fibrillary acidic protein (GFAP) and symptomatic intracranial hemorrhage (sICH) in acute ischemic stroke (AIS) patients undergoing endovascular thrombectomy (EVT) treatment remains uncertain. We aimed to assess the association between levels of GFAP in the bloodstream and the occurrence of sICH.
Methods: Between June 2019 and May 2023, 142 consecutive AIS patients undergoing EVT at Stroke Center and 35 controls from the Physical Examination Center were retrospectively included. The levels of GFAP in the bloodstream were quantified using enzyme-linked immunosorbent assay prior to endovascular treatment (T1) and 24 h after the procedure (T2). The identification of sICH was based on the Heidelberg Bleeding Classification.
Results: Serum GFAP levels at T1 in AIS patients were significantly higher than those in the controls (0.249 [0.150– 0.576] versus 0.065 [0.041– 0.110] ng/mL, p = 0.001), and there was a notably elevation in GFAP levels at T2 compared to T1 (3.813 [1.474, 5.876] versus 0.249 [0.150– 0.576] ng/mL, p = 0.001). Of the 142 AIS patients, 18 (14.5%) had sICH after EVT. Serum GFAP levels at T2 showed significant associations with sICH in both the unadjusted model (OR 1.513, 95% CI 1.269– 1.805, p = 0.001) and multivariable adjusted model (OR 1.518, 95% CI 1.153– 2.000, p = 0.003). Furthermore, the addition of GFAP at T2 to conventional model resulted in a significant enhancement of risk reclassification for sICH (integrated discrimination improvement [IDI] 0.183, 95% CI 0.070– 0.295, p = 0.001).
Conclusion: Serum GFAP levels were notably increased in AIS patients 24 h after EVT. Elevated GFAP levels were correlated to an elevated risk of sICH. GFAP could potentially serve as a dependable indicator for sICH in AIS individuals who treated with EVT.

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.20

自引率

2.80%

发文量

193

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.