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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Increased Serum Alkaline Phosphatase as a Predictor of Symptomatic Hemorrhagic Transformation in Ischemic Stroke Patients with Atrial Fibrillation and/or Rheumatic Heart Disease
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Increased Serum Alkaline Phosphatase as a Predictor of Symptomatic Hemorrhagic Transformation in Ischemic Stroke Patients with Atrial Fibrillation and/or Rheumatic Heart Disease

机译：增加血清碱性磷酸酶作为心房颤动和/或风湿性心脏病的缺血性脑卒中患者症状出血性转化的预测因子

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Background and Objective: Elevated alkaline phosphatase (ALP) is considered as a marker of liver function in clinical practice. Furthermore, it has been identified that liver function can contribute to hemorrhagic transformation (HT). However, whether ALP levels play a role in HT after stroke remains an open question, especially in cardioembolic stroke patients. Methods: We prospectively and consecutively enrolled ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease. Baseline data including ALP levels within 48 hours after admission were collected. ALP levels were divided into tertiles. The presence of HT, hemorrhagic infarction (HI), parenchymal hematoma (PH), and symptomatic HT was evaluated according to brain magnetic resonance imaging and European-Australasian Acute Stroke Study III definitions. We used logistic regression to examine the associations between ALP levels and risk of HT, HI, PH, and symptomatic HT. Results: Of the 130 patients (56 male; mean age: 63 years) included finally, 50 (38.5%) developed HT and 13 (10.0%) developed symptomatic HT. ALP levels were not associated with risk of HT, HI, and PH. However, compared with the first ALP tertile, patients in the third tertile were 8.96 times more likely to have symptomatic HT (95% confidence interval: 1.33-60.21; P=.02) after adjusting for age, gender, alanine aminotransferase levels, aspartate aminotransferase levels, antiplatelet therapy, anticoagulation therapy, and thrombolysis therapy. Conclusion: Elevated ALP levels may help identify highrisk symptomatic HT in ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease. However, further studies with larger cohorts are needed to identify our results.
机译：背景和目的：升高的碱性磷酸酶（ALP）被认为是临床实践中肝功能的标志物。此外，已经鉴定出肝功能可以有助于出血性转化（HT）。然而，如果中风仍然是开放的问题，ALP水平是否在HT中发挥作用，特别是在心脏栓塞患者中。方法：我们潜在和连续招收心房颤动和/或风湿性心脏病的缺血性脑卒中患者。收集入院后48小时内的基线数据包括ALP水平。 ALP水平分为泰利物。根据脑磁共振成像和欧洲澳大利亚急性中风研究III定义，评估HT，出血性梗死（HI），实质血肿（pH）和症状HT的存在。我们使用Logistic回归来检查ALP水平与HT，HI，pH和症状HT的风险之间的关联。结果：130名患者（56名雄性;平均年龄：63岁）最终，50（38.5％）发育了HT和13（10.0％）发育症状HT。 ALP水平与HT，HI和pH的风险无关。然而，与第一个Alp Tertile相比，第三张菌株中的患者患有症状HT的患者患者患者的患者（95％置信区间：1.33-60.21; p = .02）调整年龄，性别，丙氨酸氨基转移酶水平，天冬氨酸后氨基转移酶水平，抗血小板治疗，抗凝治疗和溶栓治疗。结论：升高的ALP水平可能有助于识别心房颤动和/或风湿性心脏病的缺血性卒中患者中的高常数症状HT。然而，需要进行更大的群组的进一步研究来识别我们的结果。

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