Stroke is a leading cause of death and disability. Here, we examine whether point-of-care measurement of the purines, adenosine, inosine and hypoxanthine, which are downstream metabolites of ATP, has potential to assist the diagnosis of stroke. In a prospective observational study, patients who were suspected of having had a stroke, within 4.5 h of symptom onset and still displaying focal neurological symptoms at admission, were recruited. Clinical research staff in the Emergency Departments of two hospitals used a prototype biosensor array, SMARTCap, to measure the purines in the venous blood of stroke patients and healthy controls. In controls, the baseline purines were 7.1 ± (SD) 4.2 μM (n = 52), while in stroke patients, they were 11.6 ± 8.9 μM (n = 76). Using the National Institutes for Stoke Scale (NIHSS) to band the severity of stroke, we found that minor, moderate and severe strokes all gave significant elevation of blood purines above the controls. The purine levels fall over 24 h. This was most marked for patients with haemorrhagic strokes (5.1 ± 3.6 μM, n = 9 after 24 h). The purine levels measured on admission show a significant correlation with the volume of affected brain tissue determined by medical imaging in patients who had not received thrombolysis or mechanical thrombectomy.ClinicalTrials.gov Identifier: NCT02308605

中文翻译：

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即时护理测量显示嘌呤释放到中风患者的静脉血中。

中风是导致死亡和残疾的主要原因。在这里，我们检查了嘌呤，腺苷，肌苷和次黄嘌呤（它们是ATP的下游代谢产物）的即时护理测量是否具有潜力来辅助中风的诊断。在一项前瞻性观察性研究中，招募了被怀疑患有中风，在症状发作4.5小时内仍在入院时仍表现出局灶性神经系统症状的患者。两家医院急诊室的临床研究人员使用原型生物传感器阵列SMARTCap测量中风患者和健康对照者静脉血中的嘌呤。在对照中，基线嘌呤为7.1±（SD）4.2μM（n  = 52），而在中风患者中，基线嘌呤为11.6±8.9μM（n = 76）。使用美国国立中风研究院卒中量表（NIHSS）来确定中风的严重程度，我们发现轻度，中度和重度中风都会使血嘌呤明显高于对照。嘌呤水平下降超过24小时。这在出血性中风患者中最为明显（5.1±3.6μM， 24小时后n = 9）。入院时测量的嘌呤水平与未接受溶栓或机械血栓切除术的患者通过医学成像确定的受影响脑组织的体积显着相关。ClinicalTrials.gov标识符：NCT02308605