在中风中的炎症:初始的CRP水平可以预测内血管治疗中风患者的不良结果
Tom Finck1, Philipp Sperl1, Moritz Hernandez-Petzsche1
1Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Frontiers in neurology
|June 26, 2023
概括
缺血性中风机械血栓切除术前C-反应蛋白 (CRP) 的升高表明不良结果和死亡率的风险更高. 这种炎症标志物对心房的患者尤为重要.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 炎症研究 炎症研究
背景情况:
- 通过C反应蛋白 (CRP) 表示的全身炎症与心血管和脑血管疾病的不良预后有关.
- 在中风中常见的缺血会增加CRP,这表明它可能反映了组织的脆弱性.
- 在接受机械血栓切除术 (MT) 的急性缺血性中风患者中,治疗前CRP的预后作用仍未完全阐明.
研究的目的:
- 调查C反应蛋白 (CRP) 水平在缺血性中风急性阶段的预测值.
- 评估大血管封闭性中风患者在机械前血栓切除术 (MT) 之前的CRP水平与临床结果 (包括死亡率) 之间的关联.
主要方法:
- 一项观察性病例控制研究分析了676名用MT治疗的大血管封闭的患者.
- 使用单变量和多变量模型来评估CRP和白细胞病的预后意义.
- 临床结果 (修改的兰金得分>2) 和90天全因死亡率与入院CRP水平相关评估.
主要成果:
- 在46.3%的患者 (313/676) 中观察到升高的入院CRP (≥5 mg/l).
- 患有CRP升高的患者表现出明显更高的临床结果不佳率 (64.5%与42.1%,p < 0.0001) 和90天死亡率 (25.2%与9.4%,p < 0.0001).
- 在MT前的CRP水平高度预测受损的结局,特别是在心房的患者中,并且与MT后的CRP水平增加相关.
结论:
- 机械血栓切除术前C-反应蛋白水平升高与缺血性中风患者的临床结果明显恶化和死亡率增加有关.
- 炎症标志物,特别是CRP,对于风险分层至关重要,特别是在中风患者中,心房动.
- 这些发现强调了评估系统性炎症在急性缺血性中风管理中的重要性.
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