循环炎症生物标志物与ICH后的功能性结果或周 hematomal oedema之间的关联:一个系统的审查和元分析
Caoimhe Kirby1,2,3, Jack Barrington1,2,3, Lotte Sondag4
1Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK.
Wellcome open research
|December 1, 2023
概括
周围血液中纤维素和高流动性组盒蛋白1 (HMGB1) 的较高水平与脑内出血 (ICH) 患者的结果较差有关. 这表明炎症在ICH进展和患者康复中起着关键作用.
科学领域:
- 神经科学是一个神经科学.
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
背景情况:
- 目前,脑内出血 (ICH) 缺乏特定的医学治疗方法.
- 在急性脑损伤后的炎症反应提供了潜在的治疗途径.
- 已知外周免疫反应受到大脑损伤的影响,这表明外周生物标志物和ICH结果之间存在联系.
研究的目的:
- 调查周围血液中的炎症生物标志物与ICH后的临床结果之间的关联.
- 探讨这些生物标志物与神经炎症指标周 hematomal oedema (PHO) 之间的关系.
主要方法:
- 在OVID Medline和EMBASE上进行了系统的文献搜索,对ICH患者的研究进行了测量炎症生物标志物和临床结果或PHO的研究.
- 偏差风险是使用既定指南 (纽卡斯尔-太华尺度,STROBE-ME,REMARK,QUIPS) 进行评估的.
- 采用随机效应元分析,将生物标志物与PHO的关联和功能结果的数据汇集在一起.
主要成果:
- 93项涉及17702名参与者的研究检查了生物标志物与临床结果的关联,而16项研究 (1299名参与者) 专注于PHO.
- 对20项研究 (3,199名参与者) 的分析显示,较高的纤维素和高流动性组盒蛋白1 (HMGB1) 水平与ICH后90天死亡或依赖性增加有关.
- 虽然升高的白细胞 (WBC) 和C-反应蛋白 (CRP) 显示出初始与不良结果的关联,但在偏差评估或调整后,这些并非始终显著.
结论:
- 纤维素素和HMGB1的循环水平升高与脑内出血后临床结果较差显著相关.
- 这些发现强调了ICH炎症反应的临床相关性.
- 需要进一步的研究来确定这些关联是否由PHO调解,以及这些生物标志物是否代表可行的治疗点.
相关概念视频
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
96
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
96
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
167
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
167