Correlation between serum adenosine deaminase level and prognosis of intravenous thrombolysis in patients with acute cerebral infarction
Objective To investigate the correlation between serum adenosine deaminase(ADA)level and prognosis of intravenous thrombolysis in patients with acute cerebral infarction(ACI).Methods This study was a cohort study.A total of 188 ACI patients who received intravenous thrombolysis in Yan'an University Xianyang Hospital from May 2021 to March 2023 were selected as the study objects,including 105 males and 83 females,aged 51-76(64.25±6.94)years.All 188 patients were treated with intravenous thrombolysis and were admitted to hospital for re-examination 90 days later.The general data[gender,age,weight,smoking history,underlying diseases,National Institutes of Health Stroke Scale(N1HSS)score at admission,time from onset to thrombolysis,etc.],laboratory indicators[low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),triglyceride(TG),platelet count(PLT),fibrinogen(Fib),etc.],serum ADA,adenosine,and uric acid levels,and modified Rankin scale(MRS)score were collected.Independent sample t test and x2 test were used for statistical analysis.The correlation analysis was carried out by Pearson correlation analysis.Multivariate logistic regression analysis was used to analyze the factors affecting the prognosis in patients with ACI.The value of serum ADA level in predicting poor prognosis in ACI patients was analyzed by receiver operating characteristic curve(ROC).Results According to the MRS score of 188 ACI patients who received intravenous thrombolysis,127(67.55％)had good prognosis and 61(32.45％)had poor prognosis.The NIHSS score at admission and serum LDL-C,Fib,ADA,and uric acid levels of the poor prognosis group were higher than those of the good prognosis group[(13.97±3.95)points vs.(11.81±3.90)points,(2.95±0.66)mmol/L vs.(2.46±0.73)mmol/L,(3.32±0.78)g/L vs.(2.63±0.73)g/L,(21.30±6.62)U/L vs.(16.40±5.39)U/L,(306.42±50.29)μmol/L vs.(269.76±50.37)μmol/L],and the level of serum adenosine was lower than that of the good prognosis group[(261.62±85.29)μg/L vs.(312.47±93.40)μg/L](all P＜0.05).Pearson correlation analysis showed that serum ADA level was positively correlated with NIHSS score and serum LDL-C,Fib,and uric acid levels,and was negatively correlated with serum adenosine level in ACI patients(all P＜0.05).Multivariate logistic regression analysis showed that NIHSS score at admission and serum LDL-C,Fib,ADA,and uric acid levels were all risk factors for poor prognosis of intravenous thrombolysis in ACI patients,and serum adenosine level was a protective factor(all P＜0.05).The area under the curve of serum ADA level for predicting poor prognosis of ACI patients was 0.727(95％CI:0.654-0.801),with a critical value of 17.25 U/L,sensitivity of 70.5％,and specificity of 71.7％.Conclusion Serum ADA level is negatively correlated with the prognosis of intravenous thrombolysis in ACI patients,and high ADA level may indicate poor prognosis of intravenous thrombolysis.
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