Correlation and predictive value analysis of serum antithrombin Ⅲ,lactate dehydrogenase and procalcitonin with the efficacy of thrombolytic therapy for cerebral infarction
Objective To explore the correlation and predictive value of serum antithrombin Ⅲ(TAT),lactate dehydrogenase(LDH),procalcitonin(PCT)with the efficacy of thrombolytic therapy for cerebral infarction.Methods A total of 140 patients with cerebral infarction who visited our hospital from May 2021 to April 2023 were collected.All patients received intravenous thrombolysis treatment,and the thrombolysis effect was evaluated by the NIHSS.Based on the thrombolysis effect,the patients were grouped into the poor thrombolysis effect group and the good thrombolysis effect group.Fasting venous blood was collected from patients at admission,24 h of treatment and 5 d of treatment,and serum levels of TAT,LDH,and PCT were detected by ELISA.Pearson and Spearman methods were applied to analyze the correlation between serum TAT,LDH and PCT in patients at 5 d after treatment with poor thrombolysis efficacy,and the correlation between the three items and the NIHSS score reduction rate,respectively.ROC curve was applied to analyze the diagnostic value of serum TAT,LDH,and PCT for poor thrombolysis efficacy.Logistic regression was applied to analyze the factors that affected the poor thrombolysis effect.Results Serum levels of TAT,LDH,and PCT were significantly lower in patients with cerebral infarction at 24 h and 5 d after treatment compared with patients before treatment,and serum levels of TAT,LDH,and PCT were significantly lower in patients with cerebral infarction at 5 d after treatment compared with patients at 24 h after treatment(all P＜0.05).Compared with those in the good thrombolysis effect group,the NIHSS score reduction rate was obviously reduced in the poor thrombolysis effect group,and serum TAT,LDH,and PCT were obviously increased(all P＜0.05).The serum TAT in the poor thrombolysis effect group showed a positive correlation with LDH and PCT,while the serum LDH and PCT showed a positive correlation.Spearman analysis showed that there was a negative correlation between serum TAT,LDH,PCT,and NIHSS score reduction rate in patients with poor thrombolysis effect.The area under the curve of serum TAT,LDH,PCT and their combination in diagnosing poor efficacy in thrombolytic therapy for cerebral infarction was 0.863,0.833,0.833 and 0.919,respectively,and the combination of the three was superior to their respective individual diagnoses(Z=1.976,Z=3.365,Z=2.946;P=0.048,P=0.000,P=0.003);serum TAT,LDH,PCT and NIHSS score reduction rate were independent influencing factors for poor efficacy of thrombolytic therapy for cerebral infarction(all P＜0.05).Conclusions The high expression of serum TAT,LDH and PCT may be related to the poor efficacy of thrombolytic therapy for cerebral infarction,and has certain predictive value for the effectiveness of thrombolytic therapy.The combined diagnostic efficacy of the three factors is increased.
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