The change of serum alkaline phosphatase in patients with acute cerebral infarction and its clinical significance / 中华老年医学杂志

ABSTRACT

Objective To investigate the change of serum alkaline phosphatase (ALP) level in patients with acute cerebral infarction (ACI) and its clinical significance.Methods A total of 400 patients with ACI (ACI group) and 240 gender-and age-matched healthy controls during the same period were enrolled in this study.Serum ALP,total protein,alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and other indicators of liver function,serum creatinine (Cr),blood urea nitrogen (BUN) and other indexes of renal function were determined.ACI patients were divided into three subgroups according to the largest diameter of infarction slice on the diffusion weighted imaging (DWI)small area group (＜1.5cm),middle area group (1.5-4.0cm) and large area group (＞4.0cm).The degree of neurologic impairment at admission and the degree of nerve function recovery at discharge were assessed by National Institute of Health stroke scale (NHISS) and modified-Rankin Scale (mRS) in all patients.The relationship of serum ALP level with infarction area,NHISS score and mRS was analyzed.Results Serum ALP level was higher in ACI group than in control group [(80.1±24.4)U/L vs.(75.5±21.5)U/L,t=-2.471,P=0.014].Serum ALP level was elevated along with the increase of infarction areas in ACI group [(78.0 ± 23.3)U/L,(79.4±24.9) U/L vs.(87.7±26.0) U/L,F=4.374,P=0.013].The correlation analysis showed that serum ALP level was positively correlated with infarction area (r=0.118,P=0.019) and NHISS score (r=0.114,P=0.023),but no significant relationship was found with mRS (r=0.071,P=0.08).Multivariate regression analysis revealed that patients with high serum ALP level (＞86 U/L) had 1.691-fold higher risk for cerebral infarction than did those with low serum ALP level(＜67 U/L) (OR=1.691,95％CI1.103～2.594) after adjusting for confounding variables including age,gender,hypertension,diabetic mellitus,heart disease (coronary heart disease and atrial fibrillation),et al.Receiver operating curves (ROC) analysis revealed that the area under the curve of serum ALP level for predicting ACI was 0.557 (95％CI0.512～0.602,P=0.016),and its sensitivity and specificity were 43.1％ and 67.6 ％ respectively when serum ALP level was 81.5 U/L.Conclusions Serum ALP level is increased in ACI patients,which has positive correlations with cerebral infarction areas and NHISS scores.In the future,maybe,we could assess ACI by monitoring serum ALP levels or improve the prognosis of ACI patients by decreasing serum ALP levels in the future.