血清学标志物预测青年缺血性卒中复发的研究进展

Research advances in serological markers for predicting the recurrence of ischemic stroke in young adults

摘要:

近年来，青年缺血性卒中发病率显著上升，其长期复发风险备受关注。现有研究表明，神经丝轻链（NfL）、胶质纤维酸性蛋白（GFAP）、白细胞介素-6（IL-6）、可溶性CD40配体（sCD40L）、D-二聚体/纤维蛋白原比值（DFR）等血清学标志物可反映神经损伤、胶质细胞活化、炎症反应、血小板激活及凝血–纤溶系统失衡等关键病理过程，也为复发风险预测提供了潜在生物学基础。此外，新兴的外泌体microRNA谱和蛋白质组学指标（如钙结合蛋白／载脂蛋白C3）等的发现，进一步深化了对卒中复发分子机制的认知。该文基于最新国内外研究进展，聚焦上述血清学标志物（涵盖传统与新型标志物）与青年缺血性卒中复发的关联，深入剖析其内在作用机制，旨在为临床精准评估青年缺血性卒中患者的复发风险，制定个体化二级预防策略提供科学依据。

Abstract:

In recent years， there has been a significant increase in the incidence rate of ischemic stroke among young adults， and the risk of long-term recurrence has attracted much attention. Current studies have shown that serological markers， such as neurofilament light chain， glial fibrillary acidic protein， interleukin-6， soluble CD40 ligand， and D-dimer/fibrinogen ratio， can reflect the key pathological processes of nerve injury， glial cell activation， inflammatory response， platelet activation， and coagulation-fibrinolytic system imbalance， and these markers also provide a potential biological basis for predicting the risk of recurrence. Furthermore， the identification of emerging exosomal miRNA profiles and proteomic indicators （such as S100A12 and ApoC3） has further deepened the understanding of the molecular mechanisms for the recurrence of stroke. Based on the latest research advances in China and globally， this article focuses on the association between the above serological markers （covering both traditional and novel markers） and the recurrence of ischemic stroke in young adults and analyzes their underlying mechanisms of action， in order to provide a scientific basis for accurately assessing the risk of recurrence in young patients with ischemic stroke and developing individualized secondary prevention strategies.