Recent Advances in Biochemical Markers Commonly Measured in Hospital Settings for Predicting Post-stroke Disability

doi:10.12114/j.issn.1007-9572.2018.00.117

Abstract

Abstract: Stroke is one of the main chronic non-communicable diseases threatening human health.Although the mortality rate has decreased with the development of medical technology，the functional disorders after stroke have seriously affected the quality of life of survivors.Biochemical test is fast and reliable，which can predict the development and prognosis of stroke.We mainly focused on the biochemical markers often detected in hospital settings for predicting post-stroke disability，hoping to offer help for optimizing the allocation of medical resources，and to provide theoretical support for the development of intervention and health management models for patients with post-stroke disability.

Key words:
Stroke, Disability, Biological markers, Forecasting, Review

摘要： 脑卒中是威胁人类健康的主要慢性非传染性疾病之一，随着医疗技术发展其病死率虽已下降，但造成的功能障碍严重影响幸存者的生活质量。血液生化指标检验速度快且结果可靠，可预测脑卒中的发展及预后。本研究综述医院常测生化指标对脑卒中后残疾的预测能力，有助于医疗资源优化配置，为建立脑卒中后残疾患者干预及健康管理模式提供思路及理论依据。

关键词: 卒中, 残疾, 生物学标记, 预测, 综述

HE Yudi,LYU Yumei. Recent Advances in Biochemical Markers Commonly Measured in Hospital Settings for Predicting Post-stroke Disability[J]. Chinese General Practice, 2019, 22(5): 511-515. DOI: 10.12114/j.issn.1007-9572.2018.00.117.
何宇迪,吕雨梅. 医院常测生化指标对脑卒中后残疾风险预测的研究进展[J]. 中国全科医学, 2019, 22(5): 511-515. DOI: 10.12114/j.issn.1007-9572.2018.00.117.

References

［1］GONZáLEZ-GóMEZ F J，PéREZ-TORRE P，DEFELIPE A，et al．Stroke in young adults：incidence rate，risk factors，treatment and prognosis［J］．Rev Clin Esp，2016，216（7）：345-351．DOI：10.1016/j.rce.2016.05.008.
［2］GADIDI V，KATZ-LEURER M，CARMELI E，et al．Long-term outcome poststroke：predictors of activity limitation and participation restriction［J］．Arch Phys Med Rehabil，2011，92（11）：1802-1808．DOI：10.1016/j.apmr.2011.06.014.
［3］MCCULLY K S.Vascular pathology of homocysteinemia：implications for the pathogenesis of arteriosclerosis［J］．Am J Pathol，1969，56（1）：111-128.
［4］JI Y，SONG B，XU Y，et al．Prognostic significance of homocysteine levels in acute ischemic stroke：a prospective cohort study［J］．Curr Neurovasc Res，2015，12（4）：334-340．DOI：10.2174/1567202612666150807112205.
［5］KWON H M，LEE Y S，BAE H J，et al．Homocysteine as a predictor of early neurological deterioration in acute ischemic stroke［J］．Stroke，2014，45（3）：871-873．DOI：10.1161/STROKEAHA.113.004099.
［6］TU W J，ZHAO S J，LIU T G，et al．Combination of high-sensitivity C-reactive protein and homocysteine predicts the short-term outcomes of Chinese patients with acute ischemic stroke［J］．Neurol Res，2013，35（9）：912-921．DOI：10.1179/1743132813Y.0000000228.
［7］PNIEWSKI J，CHODAKOWSKA-ZEBROWSKA M，WOZNIAK R，
et al．Plasma homocysteine level and the course of ischemic stroke［J］．Acta Neurobiol Exp（Wars），2003，63（2）：127-130.
［8］ZHONG C，LV L，LIU C，et al．High homocysteine and blood pressure related to poor outcome of acute ischemia stroke in Chinese population［J］．PLoS One，2014，9（9）：e107498．DOI：10.1371/journal.pone.0107498.
［9］SAXENA A，ANDERSON C S，WANG X，et al．Prognostic significance of hyperglycemia in acute intracerebral hemorrhage：the INTERACT2 study［J］．Stroke，2016，47（3）：682-688．DOI：10.1161/STROKEAHA.115.011627.
［10］YAO M，NI J，ZHOU L，et al．Elevated fasting blood glucose is predictive of poor outcome in non-diabetic stroke patients：a sub-group analysis of SMART［J］．PLoS One，2016，11（8）：e0160674．DOI：10.1371/journal.pone.0160674.
［11］DEL ZOPPO G J，LEVY D W，WASIEWSKI W W，et al．Hyperfibrinogenemia and functional outcome from acute ischemic stroke［J］．Stroke，2009，40（5）：1687-1691.
［12］SWAROWSKA M，JANOWSKA A，POLCZAK A，et al．The sustained increase of plasma fibrinogen during ischemic stroke predicts worse outcome independently of baseline fibrinogen level［J］．Inflammation，2014，37（4）：1142-1147．DOI：10.1007/s10753-014-9838-9.
［13］L?PP?NEN P，QIAN C，TETRI S，et al．Predictive value of C-reactive protein for the outcome after primary intracerebral hemorrhage［J］．J Neurosurg，2014，121（6）：1374-1379.
［14］GENG H H，WANG X W，FU R L，et al．The relationship between C-reactive protein level and discharge outcome in patients with acute ischemic stroke［J］．In J Environ Res Public Health，2016，13（7）：636-647．DOI：10.3390/ijerph13070636.
［15］NAVE A H，LANGE K S，LEONARDS C O，et al．Lipoprotein （a） as a risk factor for ischemic stroke：a meta-analysis［J］．Atherosclerosis，2015，242（2）：496-503.
［16］FUKUSHIMA M，KOBAYASHI Y，FUKUO Y，et al．Changes in serum Lp（a） and apo（a）phenotype in patients with acute cerebral stroke［J］．Nihon Ronen Igakkai Zasshi，1996，33（11）：852-861.
［17］ZHANG W，ZHANG X A.Prognostic value of serum lipoprotein（a） levels in patients with acute ischemic stroke［J］．Neuroreport，2014，25（4）：262-266.
［18］LI S Y，GAO Y，MA W N，et al．The relationship between serum lipoprotein（a） levels and ischemic stroke risk：a cohort study in the Chinese population［J］．Inflammation，2014，37（3）：686-693．DOI：10.1007/s10753-013-9785-x.
［19］黄美媚，李国兴，游文霞，等．血清白蛋白水平对急性缺血性脑卒中患者预后的研究［J］．中国医药指南，2015，13（35）：52-53.
HUANG M M，LI G X，YOU W X，et al．Study on the prognosis of acute ischemic stroke patients with serum albumin level［J］．Guide of China Medicine，2015，13（35）：52-53.
［20］刘艳，宋彧琳，周丹，等．急性缺血性脑卒中患者血清白蛋白和球蛋白与短期预后的关系［J］．中国现代医学杂志，2015，25（21）：73-79.
LIU Y，SONG X L，ZHOU D，et al．Relationship of albumin and globulin levels with short-term prognosis in acute ischemic stroke patients［J］．China Journal of Modern Medicine，2015，25（21）：73-79.
［21］张婧.英国卒中国家指南关于吞咽、喂食和营养的管理指南简介［J］．中国卒中杂志，2007，2（3）：258.
ZHANG J.Swallowing，feeding and nutrition：assessment and management of dysphagia and nutrition［J］．Chinese Journal of Stroke，2007，2（3）：258.
［22］YEH P S，YANG C M，LIN S H，et al．Low levels of high-density lipoprotein cholesterol in patients with atherosclerotic stroke：a prospective cohort study［J］．Atherosclerosis，2013，228（2）：472-477．DOI：10.1016/j.atherosclerosis.2013.03.015.
［23］王洪伟.血脂水平与脑卒中的关系研究［J］．中国医药科学，2016，6（18）：201-203，212.
WANG H W.Study on the relationship between blood lipid level and stroke［J］．China Medicine and Pharmacy，2016，6（18）：201-203，212.
［24］KANG K，LEE J J，PARK J M，et al．High nonfasting triglyceride concentrations predict good outcome following acute ischaemic stroke［J］．Neurol Res，2017，39（9）：779-786．DOI：10.1080/01616412.2017.1349567.
［25］PIKIJA S，TRKULJA V，JUVAN L，et al．Higher on-admission serum triglycerides predict less severe disability and lower all-cause mortality after acute ischemic stroke［J］．J Stroke Cerebrovasc Dis，2013，22（7）：e15-24.
［26］CHOI K H，PARK M S，KIM J T，et al．Serum triglyceride level is an important predictor of early prognosis in patients with acute ischemic stroke［J］．J Neurol Sci，2012，319（1/2）：111-116．DOI：10.1016/j.jns.2012.04.018.
［27］ARSALAN，ISMAIL M，KHATTAK M B，et al．Prognostic significance of serum bilirubin in stroke［J］．J Ayub Med Coll Abbottabad，2011，23（2）：104-107.
［28］KIMM H，YUN J E，JO J，et al．Low serum bilirubin level as an independent predictor of stroke incidence：a prospective study in Korean men and women［J］．Stroke，2009，40（11）：3422-3427．DOI：10.1161/STROKEAHA.109.560649.
［29］LUO Y，LI J，ZHANG J，et al．Elevated bilirubin after acute ischemic stroke linked to the stroke severity［J］．Int J Dev Neurosci，2013，31（7）：634-638．DOI：10.1016/j.ijdevneu.2013.08.002.
［30］KAWASE S，KOWA H，SUTO Y，et al．Association between serum uric acid level and activity of daily living in Japanese patients with ischemic stroke［J］．J Stroke Cerebrovasc Dis，2017，26（9）：1960-1965．DOI：10.1016/j.jstrokecerebrovasdis.2017.06.017.
［31］张晓龙，张金涛，彭颖，等．血清尿酸水平与急性脑卒中短期临床结局的关系［J］．中华流行病学杂志，2012，33（5）：529-533．DOI：10.3760/cma.j.issn.0254-6450.2012.05.019.
ZHANG X L，ZHANG J T，PENG Y，et al．Association between serum uric acid and short-term clinical outcome among patients with acute stroke［J］．Chinese Journal of Epidemiology，2012，33（5）：529-533．DOI：10.3760/cma.j.issn.0254-6450.2012.05.019.
［32］WANG Z，LIN Y，LIU Y，et al．Serum uric acid levels and outcomes after acute ischemic stroke［J］.Mol Neurobiol，2016，53（3）：1753-1759．DOI：10.1007/s12035-015-9134-1.
［33］WU H，JIA Q，LIU G，et al．Decreased uric acid levels correlate with poor outcomes in acute ischemic stroke patients，but not in cerebral hemorrhage patients［J］．J Stroke Cerebrovasc Dis，2014，23（3）：469-475．DOI：10.1016/j.jstrokecerebrovasdis.2013.04.007.
［34］ZHANG X，HUANG Z C，LU T S，et al．Prognostic significance of uric acid levels in ischemic stroke patients［J］．Neurotox Res，2016，29（1）：10-20．DOI：10.1007/s12640-015-9561-9.
［35］FATHI D，NOMALI M，NADERI H．Total serum cholesterol level and prognosis of acute cerebral ischemic stroke［J］．Healthmed，2015，9（2）：39-44.
［36］ZHAO W，AN Z，HONG Y，et al．Low total cholesterol level is the independent predictor of poor outcomes in patients with acute ischemic stroke：a hospital-based prospective study［J］．BMC Neurol，2016，16（1）：36．DOI：10.1186/s12883-016-0561-z.
［37］CUI R，ISO H，YAMAGISHI K，et al．High serum total cholesterol levels is a risk factor of ischemic stroke for general Japanese population：the JPHC study［J］．Atherosclerosis，2012，221（2）：565-569.
［38］ZHANG Y，TUOMILEHTO J，JOUSILAHTI P，et al．Total and high-density lipoprotein cholesterol and stroke risk［J］．Stroke，2012，43（7）：1768-1774.
［39］CHUNG J W，RYU W S，KIM B J，et al．Elevated calcium after acute ischemic stroke：association with a poor short-term outcome and long-term mortality［J］．J Stroke，2015，17（1）：54-59．DOI：10.5853/jos.2015.17.1.54.
［40］GUPTA A，DUBEY U，KUMAR A，et al．Correlation of serum calcium levels with severity and functional outcome in acute ischemic stroke patients［J］．Int J Res Med Sci，2015，3（12）：3698-3702．DOI：10.18203/2320-6012.ijrms20151425.
［41］FENG X Y，WANG Z X，MA T，et al．Calcium intake and the risk of stroke［J］．Int J Clin Exp Med，2016，9（8）：16016-16024.
［42］APPEL S A，MOLSHATZKI N，SCHWAMMENTHAL Y，et al．Serum calcium levels and long-term mortality in patients with acute stroke［J］．Cerebrovasc Dis，2011，31（1）：93-99.

[1]	TIAN Chen, LIU Jianing, TIAN Jinhui, GE Long. Living Systematic Reviews: Methods and Processes for Development [J]. Chinese General Practice, 2025, 28(30): 3853-3860.
[2]	WANG Tingting, TANG Yong, ZHANG Wenke, LI Zhigang. Research Progress on Exercise Intervention of Hyperuricemia [J]. Chinese General Practice, 2025, 28(30): 3841-3846.
[3]	ZHOU Sheng, DENG Changsheng, ZOU Guanyang, SONG Jianping. Research Progress on the Pathogenesis of Complications of Malaria in Cardiovascular Diseases [J]. Chinese General Practice, 2025, 28(27): 3466-3472.
[4]	HUANG Yulin, WANG Haoyun, LI Yanmei, XIAO Xueying. Symptom Clusters in Gastric Cancer Patients Receiving Chemotherapy: a Scoping Review [J]. Chinese General Practice, 2025, 28(26): 3338-3344.
[5]	YIN Jiahui, YANG Xinhui, WANG Jingjing, ZHANG Yajing, WANG Lijuan, FU Zuodi, KONG Xiangshuang, GUO Guangxia, LI Yufeng. Predictive Value Waist-to-height Ratio, Waist-to-hip Ratio and Body Mass Index for Metabolic Syndrome [J]. Chinese General Practice, 2025, 28(26): 3258-3263.
[6]	SHANG Zhonghua, JIANG Zhiyue, HUANG Zhaohui, YANG Xing, LIU Haiyan, ZHANG Li. Trends in Cervical Cancer Burden in China from 1990 to 2021 and Prediction for 2022 to 2035 [J]. Chinese General Practice, 2025, 28(26): 3314-3320.
[7]	WEI Jiaohua, PENG Huiru, PENG Jianye, TAN Wenting, HUANG Jine, FANG Li. Expression of the Serum MOTS-c and Its Correlation with Atrial Remodeling in Patients with Atrial Fibrillation [J]. Chinese General Practice, 2025, 28(26): 3271-3276.
[8]	LUO Xinyu, LIU Jin, CHEN Hailong. Trend Analysis of the Changing Disease Burden of Pancreatitis in China and Worldwide from 1990 to 2021 and Prediction for 2022 to 2031 [J]. Chinese General Practice, 2025, 28(26): 3321-3327.
[9]	LIU Yinyin, SUI Hongping, LI Tingting, JIANG Tongtong, SHI Tieying, XIA Yunlong. Advances in Risk Prediction Models for Cardiotoxicity Associated with Breast Cancer Treatment [J]. Chinese General Practice, 2025, 28(24): 3072-3078.
[10]	LI Jiaxin, LIU Zhonghui, XIE Shuo, FU Zhifang, SUN Dan, JIAO Hongmei. Trajectory in Biomarkers of Metabolic and Inflammatory States as Early Predictors of Chronic Critical Illness in Aging Patients [J]. Chinese General Practice, 2025, 28(24): 2993-2999.
[11]	LI Miaoxiu, ZHU Bowen, KONG Lingjun, FANG Min. Progress in Research on Clinical Assessment Tools for Conservative Treatment of Adolescent Idiopathic Scoliosis [J]. Chinese General Practice, 2025, 28(24): 3079-3088.
[12]	XIAO Yao, WAN Jun. Treatment of Venous Thromboembolism in Special Populations with Direct Oral Anticoagulants [J]. Chinese General Practice, 2025, 28(24): 3066-3071.
[13]	RUAN Wanbai, LI Junfeng, YIN Yanmei, PENG Lei, ZHU Kexiang. Research Progress of Targeted Therapy and Immunotherapy for Pancreatic Cancer [J]. Chinese General Practice, 2025, 28(23): 2950-2960.
[14]	ZHOU Lianpeng, LI Weifeng, DONG Xingang, WANG Xiaoyuan. Research Progress on the Role of Copper Homeostasis Regulation Mechanism in Cognition Disorder [J]. Chinese General Practice, 2025, 28(23): 2941-2949.
[15]	DONG Haocheng, HAO Xiao, AN Dong, LI Haohan, LI Shuren. Research Progress of Heart Failure with Supra-normal Ejection Fraction [J]. Chinese General Practice, 2025, 28(21): 2692-2696.