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瑞替普酶静脉溶栓治疗急性缺血性脑卒中患者的凝血酶原时间和炎症相关参数的预后价值。

Prognostic Values of Prothrombin Time and Inflammation-Related Parameter in Acute Ischemic Stroke Patients After Intravenous Thrombolysis with rt-PA.

机构信息

Biology Post-doctoral Research Stations, Hebei Normal University, Shijiazhuang, Hebei, China.

Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China.

出版信息

Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231198042. doi: 10.1177/10760296231198042.

Abstract

In previous studies, prothrombin time (PT), systemic inflammation response index (SIRI) and systemic immune inflammation Index (SII) levels might be the prognostic factors for patients with ischemic stroke. However, the association between these coagulation and inflammation biomarkers and prognosis in patients with acute ischemic stroke (AIS) who undergo intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) remains unclear and needs further study. Thus, this study aimed to investigate the relationship between these biomarkers and clinical prognosis after IVT in AIS patients. We included patients at the Hebei general hospital diagnosed with AIS who received standard-dose IVT with rt-PA from September 2017 to August 2022. Demographic information, vascular risk factors, laboratory test results, and other stroke-related data were collected for analysis. Clinical outcomes included short-term outcome at 24 h and functional outcome at 3 months. We enrolled 281 patients in this study. In total, 16 patients had END within 24 h, and 106 patients had an unfavorable outcome at the 3-month visit. In the multivariate analysis, PT level (OR = 1.833; 95% CI: 1.161-2.893; P = 0.009), SIRI level (OR = 2.166; 95% CI: 1.014-4.629; P = 0.046) and SII level (OR = 1.002; 95% CI: 1.000-1.003; P = 0.021) were independently associated with 3-month poor outcome in AIS patients with IVT. In conclusion, the higher PT, SIRI and SII levels were independently associated with poor prognosis in AIS patients after IVT. Additionally, PT, SIRI and SII all can be novel short-term prognostic biomarkers for AIS patients treated with IVT.

摘要

在之前的研究中,凝血酶原时间 (PT)、全身炎症反应指数 (SIRI) 和全身免疫炎症指数 (SII) 水平可能是缺血性脑卒中患者的预后因素。然而,接受重组组织型纤溶酶原激活剂 (rt-PA) 静脉溶栓 (IVT) 的急性缺血性脑卒中 (AIS) 患者中这些凝血和炎症生物标志物与预后之间的关系尚不清楚,需要进一步研究。因此,本研究旨在探讨这些生物标志物与 AIS 患者 IVT 后临床预后的关系。我们纳入了 2017 年 9 月至 2022 年 8 月在河北医科大学第一医院接受标准剂量 rt-PA 静脉溶栓的 AIS 患者。收集人口统计学信息、血管危险因素、实验室检查结果和其他与卒中相关的数据进行分析。临床结局包括 24 小时内的短期结局和 3 个月时的功能结局。本研究共纳入 281 例患者。共有 16 例患者在 24 小时内发生 END,106 例患者在 3 个月时预后不良。多变量分析显示,PT 水平(OR=1.833;95%CI:1.161-2.893;P=0.009)、SIRI 水平(OR=2.166;95%CI:1.014-4.629;P=0.046)和 SII 水平(OR=1.002;95%CI:1.000-1.003;P=0.021)与 AIS 患者 IVT 后 3 个月预后不良独立相关。总之,PT、SIRI 和 SII 水平较高与 IVT 后 AIS 患者的不良预后独立相关。此外,PT、SIRI 和 SII 均可以作为 AIS 患者接受 IVT 治疗的新型短期预后生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2183/10483974/5ae5e20ca9c2/10.1177_10760296231198042-fig1.jpg

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