Predicting functional outcome of ischemic stroke patients in Romania based on plasma CRP, sTNFR-1, D-Dimers, NGAL and NSE measured using a biochip array  

作　　者：Adina HUTANU Mihaela IANCU Rodica BALASA Smaranda MAIER Minodora DOBREANU 

机构地区：[1]Laboratory Medicine, Emergency Clinical County Hospital, Tirgu Mures, Romania [2]Advanced Medical and Pharmaceutical Research Center, University of Medicine and Pharmacy Tirgu Mutes, Tirgu Mures, Romania [3]Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy 'luliu Hatieganu', Cluj Napoca, Romania [4]First Neurological Clinic, Emergency Clinical County Hospital, Tirgu Mutes, Romania [5]Department of Neurology, University of Medicine and Pharmacy [6]Department of Laboratory Medicine, University of Medicine and Pharmacy, Tirgu Mures, Romania

出　　处：《Acta Pharmacologica Sinica》2018年第7期1228-1236,共9页中国药理学报（英文版）

摘　　要：In cerebral ischemia, evaluation of multiple biomarkers involved in various pathological pathways is a useful tool in assessing the outcome of the patients even from the early stages of the disease. In this study we investigated the utility of a panel of 5 peripheral biomarkers of inflammatory status, neuronal destruction and secondary fibrinolysis in the acute phase of ischemia, and evaluated the impact of these biomarkers on functional outcome after ischemic stroke. The 5 biomarkers （plasma CRP, D-Dimers, sTNFR-1, NGAL and NSE） were measured using a biochip array technology. Eighty nine patients in Romania were divided into 2 subgroups using the modified Rankin Scale evaluated at 3 months after ischemic stroke; the possible impact of analyzed biomarkers on unfavorable functional outcome was tested by binomial logistic regression. The subgroup with unfavorable outcome had higher concentrations of CRP, NGAL, sTNFR-1 and D-dimers, but CRP and NGAL values were not statistically different between the two subgroups. The univariate logistic regression analysis of plasma biomarkers revealed that CRP, D-Dimers, NGAL, sTNFR-1 were significant predictors of unfavorable clinical outcome. In the case of D-Dimers and sTNFR-1 we noticed an increased discrimination ability （versus baseline clinical model） to classify poor functional outcome with a tendency toward statistical signification. During the acute phase of the ischemic stroke, plasma concentrations of CRP, D-Dimers and sTNFR-1 were elevated in unfavorable outcome patients. D-Dimers and sTNFR-1 were independent predictors of poor outcome at 3 months after ischemic stroke. The biochip array technology offers the possibility to simultaneously measure several parameters involved in multiple pathophysiological pathways, in a small sample volume.In cerebral ischemia, evaluation of multiple biomarkers involved in various pathological pathways is a useful tool in assessing the outcome of the patients even from the early stages of the disease. In this study we investigated the utility of a panel of 5 peripheral biomarkers of inflammatory status, neuronal destruction and secondary fibrinolysis in the acute phase of ischemia, and evaluated the impact of these biomarkers on functional outcome after ischemic stroke. The 5 biomarkers （plasma CRP, D-Dimers, sTNFR-1, NGAL and NSE） were measured using a biochip array technology. Eighty nine patients in Romania were divided into 2 subgroups using the modified Rankin Scale evaluated at 3 months after ischemic stroke; the possible impact of analyzed biomarkers on unfavorable functional outcome was tested by binomial logistic regression. The subgroup with unfavorable outcome had higher concentrations of CRP, NGAL, sTNFR-1 and D-dimers, but CRP and NGAL values were not statistically different between the two subgroups. The univariate logistic regression analysis of plasma biomarkers revealed that CRP, D-Dimers, NGAL, sTNFR-1 were significant predictors of unfavorable clinical outcome. In the case of D-Dimers and sTNFR-1 we noticed an increased discrimination ability （versus baseline clinical model） to classify poor functional outcome with a tendency toward statistical signification. During the acute phase of the ischemic stroke, plasma concentrations of CRP, D-Dimers and sTNFR-1 were elevated in unfavorable outcome patients. D-Dimers and sTNFR-1 were independent predictors of poor outcome at 3 months after ischemic stroke. The biochip array technology offers the possibility to simultaneously measure several parameters involved in multiple pathophysiological pathways, in a small sample volume.

关 键 词：stroke biomarkers C reactive protein （CRP） the soluble receptor I of TNF alfa （sTNFR-1） D-DIMERS neuron-specific enolase（NSE） neutrophil-gelatinase associated-lipocalin （NGAL） biochip array 

分 类 号：Q512[生物学—生物化学] Q503