PT -期刊文章盟Alexandre他非盟-劳拉Mechtouff AU - Charles De布吉尼翁盟Aela Mauffrey AU - Timothe Boutelier AU - Tae-Hee赵盟Matteo Cappucci盟罗克珊娜Ameli AU - Marc Hermier AU - Laurent Derex盟诺伯特•Nighoghossian AU - Yves Berthezene TI -血脑屏障通透性和动力学炎症标记物的急性中风患者血栓切除术- 10.1212 / WNL的援助。0000000000207460 DP - 2023年8月01 TA -神经病首页学PG - e502 e511 VI - 101 IP - 5 4099 - //www.ez-admanager.com/content/101/5/e502.short 4100 - //www.ez-admanager.com/content/101/5/e502.full所以Neurology2023 8月01;101 AB -背景和目的本研究的目的是调查之间的关系基线血脑屏障(BBB)通透性和循环炎症标记物的动力学群急性缺血性中风患者(AIS)机械血栓切除术。方法患者群识别生物在中风和心血管成像标记结果包括AIS机械血栓切除术患者入院后MRI和循环炎症标记物进行连续的评估。基线动态敏感性灌注MRI是位与到达时间校正提供K2地图反映BBB通透性。coregistration表观扩散系数和K2地图后,K2的第90百分位值提取在基线缺血性核心和表示为一个百分比变化与对侧正常白质。根据平均人口一分为二K2的价值。单变量和多变量逻辑回归分析调查与预处理BBB通透性增加相关的因素在整个人口和患者出现症状& lt; 6小时。结果在整个人口(n = 105例,平均K2 = 1.59), BBB通透性增加的患者有更高的血清水平基质金属蛋白酶(MMP) 9 H48 (p = 0.02),血清c反应蛋白(CRP)水平较高H48 (p = 0.01),贫穷抵押状态(p = 0.01),和一个更大的基线缺血性核心(p & lt;0.001)。他们更可能有出血性转换(p = 0.008),最终损伤较大的体积(p = 0.02),和最差神经结果在3个月(p = 0.04)。多变量逻辑回归表明,BBB通透性增加有关只有缺血性核心体积(比值比(或)1.04,95%可信区间1.01 - -1.06,p & lt; 0.0001). Restricting analysis to patients with symptom onset <6 hours (n = 72, median K2 = 1.27), participants with an increased BBB permeability had higher serum levels of MMP-9 at H0 (p = 0.005), H6 (p = 0.004), H24 (p = 0.02), and H48 (p = 0.01), higher CRP levels at H48 (p = 0.02), and a larger baseline ischemic core (p < 0.0001). The multiple variable logistic analysis showed that increased BBB permeability was independently associated with higher H0 MMP-9 levels (OR 1.33, 95% CI 1.12–1.65, p = 0.01) and a larger ischemic core (OR 1.27, 95% CI 1.08–1.59, p = 0.04).Discussion In AIS patients, increased BBB permeability is associated with a larger ischemic core. In the subgroup of patients with symptom onset <6 hours, increased BBB permeability is independently associated with higher H0 MMP-9 levels and a larger ischemic core.ADC=apparent diffusion coefficient; AIS=acute ischemic stroke; BBB=blood-brain barrier; CRP=C-reactive protein; DSC=dynamic susceptibility contrast; DWI=diffusion-weighted imaging; FLAIR=fluid-attenuated inversion recovery; HARM=hyperacute reperfusion marker; HIR=hypoperfusion intensity ratio; HT=hemorrhagic transformation; IL=interleukin; IQR=interquartile range; MMP=matrix metalloproteinase; mRS=modified Rankin scale; MT=mechanical thrombectomy; NIHSS=NIH Stroke Scale; OR=odds ratio; TNF=tumor necrosis factor

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