The Relationship and Diagnostic Value of Plasma TM,TAFI,IL-6 and TNF-α Levels with Infarct Volume in the Ultra-early Stage of Acute Cerebral Infarction
Objective:To explore the relationship between plasma thrombomodulin(TM),thrombin activated fibrinolytic inhibitor(TAFI),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels and infarct volume in patients with acute cerebral infarction in ultra-early stage and their diagnostic value for infarct volume.Method(s):75 patients with ultra-early acute cerebral infarction admitted to the Second Affiliated Hospital of Xi'an Medical University from Jun 2018 to Sep 2019 were included in the observation group,and 75 patients with outmoded cerebral infarction admitted in the same period were included in the control group.The plasma TM,TAFI,IL-6 and TNF-α levels of patients before treatment(and within 6 hours of onset),3 days after treatment and 7 days after treatment in the observation group,and those of patients at admission in the control group were detected.The difference of the above indexes before treatment between the observation group and the control group was compared.The patients in the observation group were divided into small volume infarction group(n=27),medium volume infarction group(n=30)and large volume infarction group(n=18)according to infarction volume.The change trend and difference of the levels of the above indexes before treatment,3 days after treatment and 7 days after treatment among the three groups were compared.The correlation between the above indexes before treatment and the volume of infarction was analyzed by ordinal Logistic regression;The diagnostic value of the above indexes before treatment for large volume infarction was analyzed by ROC.Result(s):The plasma levels of TM,TAFI,IL-6 and TNF-α of patients before treatment(and within 6 hours of onset)in the observation group were higher than those of patients in the control group(P＜0.05).With the progression of the disease course,the levels of the above indexes in patients with small volume infarction,medium volume infarction and large volume infarction decreased after 3 days of treatment compared to pre-treatment levels(P＜0.05),and after 7 days of treatment,these levels continued to decrease compared to the levels at 3 days(P＜0.05).However,the overall levels of the above indexes in patients with large volume infarction were consistently higher than those in patients with medium volume infarction(P＜0.05)at each time point,and the levels in patients with medium volume infarction were higher than those in patients with small volume infarction for the aforementioned indicators(P＜0.05).Ordered Logistic regression analysis showed that the above indexes before treatment had a significant positive effect on infarction volume.It can be seen from ROC analysis that the above indexes before treatment can be used to diagnose large volume infarction,and the diagnostic value of combined detection is better.Conclusion(s):The levels of plasma TM,TAFI,IL-6 and TNF-α in patients with acute cerebral infarction increased,but decreased with the prolongation of the course of the disease,which are of great significances in the development of acute cerebral infarction;In the ultra-early stage of acute cerebral infarction,the levels of the above indexes of patients may be used to assist in diagnosing the infarction volume.
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