机构：[1]Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China[2]Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, Second Affiliated Hospital of Soochow University, Suzhou, China[3]Department of Neurology, Changshu Hospital of Traditional Chinese Medicine, Suzhou, China[4]Department of Neurology, Affiliated Wujiang Hospital of Nantong University, Suzhou, China[5]Department of Neurology, Suzhou Traditional and Western Medicine hospital, Suzhou, China[6]Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, China[7]Institutes of Neuroscience, Soochow University, Suzhou, China.
Background: The clinical impacts of serum alkaline phosphatase (ALP) and phosphate on early death are not fully understood in patients with acute ischemic stroke. We examined the associations between serum ALP, phosphate, and in-hospital mortality after ischemic stroke. Methods: Serum ALP and phosphate were measured in 2944 ischemic stroke patients from 22 hospitals in Suzhou City from December 2013 to May 2014. Cox proportional hazard models and restricted cubic splines were used to estimate the relationships between serum ALP and phosphate (both as categorical and continuous variables) and risk of in-hospital mortality. Results: During hospitalization, 111 patients (3.7%) died from all causes. After multivariable adjustment, the hazard ratio (HR) of the highest quartile compared with the lowest quartile of ALP was 2.19 (95% confidence interval [CI], 1.20-4.00) for early death. Restricted cubic spline analysis indicated a significant linear association between ALP and death (P-linearity = .017). A U-shaped association of phosphate with in-hospital mortality was observed (P-nonlinearity = .011). Compared with the third quartile of phosphate (1.08-1.21 mmol/L), HRs of the lowest and highest quartiles for early death were 2.17 (1.15-4.08) and 1.70 (.88-3.30), respectively. Sensitivity analyses further confirmed our findings. Conclusions: We observed a graded relationship between serum ALP levels and risk of early death in patients with From acute ischemic stroke. There was a U-shaped association between phosphate and all-cause mortality with significantly increased risk among patients with lower phosphate levels.
基金：
This study was supported by the National Natural Science Foundation of China (grants: 81172761, 81471195 and 81320108026), Suzhou
Clinical Research Center of Neurological Disease (Szzx201503), the Second Affiliated Hospital of Soochow University Preponderant Clinic
Discipline Group Project Funding (XKQ2015002)
第一作者机构：[1]Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
共同第一作者：
通讯作者：
通讯机构：[*1]Department of Neurology, Second Affiliated Hospital of Soochow University, Suzhou City, Jiangsu 215004, China.[*2]Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu Province 215123, China
推荐引用方式(GB/T 7714)：
Chongke Zhong ,Shoujiang You,Juping Chen,et al.Serum Alkaline Phosphatase, Phosphate, and In-Hospital Mortality in Acute Ischemic Stroke Patients[J].JOURNAL OF STROKE & CEREBROVASCULAR DISEASES.2018,27(1):257-266.doi:10.1016/j.jstrokecerebrovasdis.2017.08.041.
APA：
Chongke Zhong,,Shoujiang You,Juping Chen,Guojie Zhai,Huaping Du,...&Yonghong Zhang.(2018).Serum Alkaline Phosphatase, Phosphate, and In-Hospital Mortality in Acute Ischemic Stroke Patients.JOURNAL OF STROKE & CEREBROVASCULAR DISEASES,27,(1)
MLA：
Chongke Zhong,,et al."Serum Alkaline Phosphatase, Phosphate, and In-Hospital Mortality in Acute Ischemic Stroke Patients".JOURNAL OF STROKE & CEREBROVASCULAR DISEASES 27..1(2018):257-266
