In cerebral ischemia, evaluation of multiple biomarkers involved in various pathological pathways is a useful tool in assessing the outcome of the patients even from the early stages of the disease. In this study we investigated the utility of a panel of 5 peripheral biomarkers of inflammatory status, neuronal destruction and secondary fibrinolysis in the acute phase of ischemia, and evaluated the impact of these biomarkers on functional outcome after ischemic stroke. The 5 biomarkers (plasma CRP, D-Dimers, sTNFR-1, NGAL and NSE) were measured using a biochip array technology. Eighty nine patients in Romania were divided into 2 subgroups using the modified Rankin Scale evaluated at 3 months after ischemic stroke; the possible impact of analyzed biomarkers on unfavorable functional outcome was tested by binomial logistic regression. The subgroup with unfavorable outcome had higher concentrations of CRP, NGAL, sTNFR-1 and D-dimers, but CRP and NGAL values were not statistically different between the two subgroups. The univariate logistic regression analysis of plasma biomarkers revealed that CRP, D-Dimers, NGAL, sTNFR-1 were significant predictors of unfavorable clinical outcome. In the case of D-Dimers and sTNFR-1 we noticed an increased discrimination ability (versus baseline clinical model) to classify poor functional outcome with a tendency toward statistical signification. During the acute phase of the ischemic stroke, plasma concentrations of CRP, D-Dimers and sTNFR-1 were elevated in unfavorable outcome patients. D-Dimers and sTNFR-1 were independent predictors of poor outcome at 3 months after ischemic stroke. The biochip array technology offers the possibility to simultaneously measure several parameters involved in multiple pathophysiological pathways, in a small sample volume.

中文翻译：

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基于使用生物芯片阵列测量的血浆CRP，sTNFR-1，D-二聚体，NGAL和NSE，预测罗马尼亚缺血性中风患者的功能结局。

在脑缺血中，评估各种病理途径中涉及的多种生物标志物是评估患者预后的有用工具，甚至可以从疾病的早期开始。在这项研究中，我们调查了5种在缺血急性期炎症状态，神经元破坏和继发性纤维蛋白溶解的外周生物标志物的实用性，并评估了这些生物标志物对缺血性卒中后功能结局的影响。使用生物芯片阵列技术测量了5种生物标志物（血浆CRP，D-二聚体，sTNFR-1，NGAL和NSE）。使用改良的Rankin量表，在缺血性卒中后3个月评估了罗马尼亚的89例患者，将其分为2个亚组。通过二项式logistic回归检验分析的生物标志物对不利的功能结局的可能影响。结果不良的亚组的CRP，NGAL，sTNFR-1和D-二聚体浓度较高，但CRP和NGAL值在两个亚组之间无统计学差异。血浆生物标志物的单因素逻辑回归分析表明，CRP，D-二聚体，NGAL，sTNFR-1是不良临床预后的重要预测因子。在D-二聚体和sTNFR-1的情况下，我们注意到，对较差的功能结局进行分类的能力（相对于基线临床模型）有所提高，并具有统计学意义。在缺血性卒中的急性期，不良预后患者的血浆CRP，D-二聚体和sTNFR-1浓度升高。D-二聚体和sTNFR-1是缺血性卒中后3个月预后不良的独立预测因子。