Abstract：【Objective】To investigate the correlation between different alkaline phosphatase (ALP) levels and hemorrhagic transformation of cerebral infarction. 【Methods】 A total of 718 patients with cerebral infarction hospitalized in our hospital from January 2018 to January 2020 were selected. The ALP level was measured within 48 hours and the general baseline data were collected. According to the European collaborative study on acute stroke (ECASS Ⅲ), the hemorrhagic transformation (HT) of cerebral infarction was divided into hemorrhagic cerebral infarction (HI,n=33) and cerebral parenchymal hemorrhage (PH,n=123). Among them, the aggravation of neurological dysfunction caused by hemorrhagic transformation (NIHSS score increased by ≥ 4 points) was defined as symptomatic intracranial hemorrhage (sICH). The differences of ALP levels between hemorrhagic transformation group (HTG group) and non hemorrhagic transformation group (NHTG group) were compared. The correlation between different ALP levels and different types of hemorrhagic transformation was evaluated and analyzed by Quantile logistic regression analysis. 【Results】 There was no significant difference in the level of ALP between HI group, pH group and nhtg group (P>0.05). The level of ALP in the sICH group was significantly higher than that in NHTG group (P<0.05). Quantile regression analysis showed that different levels of ALP had no correlation with hi and pH, while high levels of ALP had significant correlation with sICH (P<0.05). 【Conclusion】Patients with cerebral infarction combined with high-level ALP are more prone to sICH transformation.
[1] LEI C,WU B,LIU M,et al.Asymptomatic hemorrhagic transformation after acute stroke:is it clinically innocuous?[J].Stroke Cerebrovasc Dis,2014,23(10):2767-2772. [2] SHIMIZU Y, IMANO H, OHIRA T, et al. Alkaline phosphatase and risk of stroke among Japanese: the Circulatory Risk in Communities Study (CIRCS)[J].J Stroke Cerebrovasc Dis,2013,22(7):1046-1055. [3] FUJII Y,TANAKA R,TAKEUCHI S,et al.Hematoma enlargement in spontaneous intracerebral hemorrhage[J].J Neurosurg,1994,80(1):51-57. [4] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病组.中国急性脑梗死后出血转化诊治共识2019[J].中华神经科杂志,2019,52(4):253-254. [5] ALVAREZ-SABIN J,MAISTERRA O,SANTAMARINA E,et al.Factors influencing haemorrhagic transformation in ischaemic stroke[J].Lancet Neurol,2013,12(7):689-705. [6] JUNFENG LIU,DEREN WANG,JIE LI,et al.Increased serum alkaline phosphatase as a predictor of symptomatic hemorrhagic transformation in ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease[J].J Stroke Cerebrovasc Dis,2016,25(10):2448-2452. [7] SHEEN C R,KUSS P,NARISAWA S, et al.Pathophysiological role of vascular smooth muscle alkaline phosphatase in medial artery calcification[J].J Bone Miner Res,2015,30(5):824-836. [8] DERACINOIS B,LENFANT A M,DEHOUCK M P,et al.Tissue non-specific alkaline phosphatase (TNAP) in vessels of the brain[J].Subcell Biochem,2015, 76(4):125-151. [9] PIKE A F, KRAMER N I,BLAAUBOER B J,et al.An alkaline phosphatase transport mechanism in the pathogenesis of Alzheimer's disease and neurodegeneration[J].Chem Biol Interact,2015,226:30-39. [10] NAYEEM F,ANDERSON K E,NAGAMANI M,et al.Alkaline phosphatase and percent body fat predict circulating c-reactive protein in premenopausal women[J].Biomarkers,2010, 15(8):663-665. [11] LUMACHI F,ERMANI M,CAMOZZI V,et al.Changes of bone formation markers osteocalcin and bone-specific alkaline phosphatase in postmenopausal women with osteoporosis[J].Ann NY Acad Sci,2009,1173:60-63. [12] TAKAKURA N,WATANABE T,SUENOBU S,et al.A role for hematopoietic stem cells in promoting angiogenesis[J].Cell,2000,102:199-209.
2021, Vol. 38 
