Systemic immune-inflammation index,serum amyloid A and N-terminal pro-brain natriuretic peptide for predicting prognosis of patients with acute cerebral infarction after thrombolytic therapy
Objective To observe the levels of systemic immune-inflammation index(SII),serum amyloid A(SAA),and N-terminal pro-brain natriuretic peptide(NT-proBNP)of patients with acute cerebral infarction,and to explore their values to the prediction of prognosis after thrombolytic therapy.Methods A total of 122 patients with acute cerebral infarction received emergency intravenous thrombolytic therapy in People's Hospital of Xinjiang Uygur Autonomous Region from June 2021 to June 2023,and were categorized into good prognosis group(n=81)and poor prognosis group(n=41)based on the outcome 6 months after thrombolytic therapy.The clinical data as underlying diseases,time from onset to thrombolytic therapy,SII,and levels of SAA,NT-proBNP,homocysteine(Hcy)and C-reactive protein(CRP)before thrombolytic therapy were compared between two groups.Spearman's correlation coefficient was used to analyze the correlations of poor prognosis with diabetes,time from onset to thrombolytic therapy,SII,and levels of SAA,NT-proBNP,Hey and CRP.Multivariate logistic regression analysis was done to assess the influencing factors of poor prognosis of patients with acute cerebral infarction after thrombolytic therapy.ROC curves were plotted to evaluate the efficiencies of single and combined detection of SII,SAA and NT-proBNP on predicting poor prognosis of patients with acute cerebral infarction.Results The proportions of diabetes and time from onset to thrombolytic therapy ≥4.5 h,SII,and levels of SAA,NT-proBNP,Hcy and CRP were higher in poor prognosis group[21.95％,39.02％,945.18±192.15,(84.32±17.37)mg/L,(679.57±125.14)ng/L,(15.87±3.51)μmol/L,(34.58±6.72)mg/L]than those in good prognosis group[7.41％,18.52％,713.04±119.01,(67.67±11.82)mg/L,(483.35±153.62)ng/L,(14.23±2.56)μmol/L,(32.23±4.60)mg/L](x2=5.340,x2=6.039,t=8.212,t=6.238,t=7.073,t=2.939,t=2.274;all P values＜0.05).The poor prognosis after thrombolytic therapy was positively correlated with diabetes,time from onset to thrombolytic therapy,SII,and levels of SAA,NT-proBNP,Hcy and CRP in patients with acute cerebral infarction(rs=0.209,P=0.021;rs=0.222,P=0.014;rs=0.559,P＜0.001;r,=0.456,P＜0.001;rs=0.566,P＜0.001;rs=0.243,P=0.007;rs=0.224,P=0.013).SII(OR=1.012,95％CI:1.005-1.018,P＜0.001),SAA(OR=1.126,95％CI:1.060-1.196,P＜0.001)and NT-proBNP(OR=1.007,95％CI:1.002-1.011,P=0.005)were the influencing factors of poor prognosis after thrombolytic therapy in patients with acute cerebral infarction.When using 880.53,79.21 mg/L and 607.32 ng/L as the optimal cut-off values of SII,SAA and NT-proBNP,the AUCs of them three alone and in combination for predicting poor prognosis after thrombolytic therapy in patients with acute cerebral infarction were 0.841(95％CI:0.759-0.924,P＜0.001),0.779(95％CI:0.689-0.869,P＜0.001),0.846(95％CI:0.773-0.918,P＜0.001)and0.957(95％CI:0.922-0.992,P＜0.001),with the sensitivities of 63.41％,60.98％,78.05％and 82.34％,and the specificities of 95.06％,83.95％,85.19％and 95.63％,respectively.The AUC of combined detection was greater than that of any single one(Z=4.021,P＜0.001;Z=3.331,P＜0.001;Z=3.320,P＜0.001).Conclusion The elevated SII and levels of SAA and NT-proBNP before thrombolytic therapy are involved in poor prognosis of patients with acute cerebral infarction after thrombolytic therapy,and the combination of SII,SAA and NT-proBNP achieves a high predictive value.
NETL
NSTL
万方数据
