Predictive value of serum uric acid,Hcy and Lp(a) before thrombolysis for the prognosis of acute ischemic stroke patients after thrombolytic therapy
Objective To investigate the predictive value of serum uric acid,homocysteine(Hcy)and lipoprotein(a)[Lp(a)]before thrombolysis in patients with acute cerebral ischemic stroke(AIS).Methods 125 AIS patients treated at the Eighth People's Hospital of Hefei City from January 2019 to January 2023 were selected for the study.According to the results of a 3-month follow-up after thrombolysis,82 pa-tients had a good prognosis,and 43 patients had a poor prognosis.Serum uric acid,Hcy and Lp(a)levels be-fore thrombolysis and other clinical data between the two groups were compared.A logistic regression model was used to analyze the factors affecting the prognosis of patients with AIS.The predictive value of serum uric acid,Hcy and Lp(a)levels before thrombolysis in AIS patients was analyzed using a receiver operating char-acteristic(ROC)curve.Results Compared to the good prognosis group,the poor prognosis group had high-er age,BMI,time from onset to thrombolysis,NIHSS score at admission,serum Hcy and Lp(a)levels,and lower serum uric acid levels.These differences were significant(t=10.563,4.086,20.083,14.177,6.103,5.494,6.980,P<0.05).In the poor prognosis group,the proportion of patients with large infarct,hyperten-sion,diabetes and atrial fibrillation was higher than in the other group.The difference was statistically signifi-cant(χ2=11.786,11.159,7.212,12.116,P<0.05).Multivariate logistic regression analysis showed that age,onset time to thrombolysis,NIHSS score at admission,pre-thrombolysis serum Hcy and Lp(a)were indepen-dent risk factors for poor prognosis in AIS patients,and a high level of serum uric acid before thrombolysis was a protective factor for prognosis.ROC curve results showed that the area under the curve(AUC)of serum uric acid,Hcy and Lp(a)levels before thrombolysis to predict the prognosis of AIS patients was 0.814,0.760 and 0.755,respectively.The AUC of the combined prediction of the three levels was 0.920,indicating that the predictive value of the combined detection was higher than that of the single index(P<0.05).Conclusion For the prognosis of acute ischemic stroke patients,serum uric acid,Hcy and Lp(a)levels before thromboly-sis have a certain predictive value.The combined detection of these biomarkers has higher predictive efficacy.
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