临床常规血液生物标志物的价值在预测中风后的长期死亡率
Isra Hatab1, Markus Kneihsl1,2, Egbert Bisping3
1Department of Neurology, Medical University of Graz, Graz, Austria.
N-终端亲B型尿素 (NT-proBNP) 是预测缺血性中风后长期死亡率的最重要的血液生物标志物. 升高的NT-proBNP水平可以识别高风险中风患者,他们可能会从早期的心血管评估和随访中受益.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 生物标志物研究 生物标志物研究
背景情况:
- 缺血性中风带来了显著的死亡风险.
- 现有的研究往往侧重于单个或实验性生物标志物,随访时间短.
- 临床实用性需要长期结果的验证预测因素.
研究的目的:
- 为了比较各种常规血液生物标志物对中风后死亡率的预测值.
- 评估这些生物标志物在长达5年的随访期内.
主要方法:
- 对连续性缺血性中风患者的前性单中心研究.
- 在入院后24小时内分析常规血液生物标志物 (炎症,心力衰竭,代谢,凝血).
- 死亡率评估的5年随访时间.
主要成果:
- 在405名患者中,17.8%的患者在5年内死亡.
- 虽然几种生物标志物显示了不可变的关联,但只有NT-proBNP独立预测死亡率 (aOR 5.1,p < 0.001).
- NT-proBNP水平≥794 pg/mL预测死亡率,灵敏度为90%,预测值为97%负,并且与心血管血栓性中风和心力衰竭有关.
结论:
- NT-proBNP是预测缺血性中风后长期死亡率的最相关的常规血液生物标志物.
- 升高的NT-proBNP标识了一个易受伤害的患者子组.
- 早期的心血管评估和持续的随访可能会改善这些患者的治疗结果.
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