The value of serum TSG-6 and ABCA1 in predicting hemorrhagic transformation after thrombolysis and its relation-ship with short term prognosis in patients with acute ischemic stroke
The value of serum TSG-6 and ABCA1 in predicting hemorrhagic transformation after thrombolysis and its relation-ship with short term prognosis in patients with acute ischemic stroke
Objective To investigate the value of serum tumor necrosis factorαstimulated gene 6(TSG-6)and ATP binding cassette subfamily A member 1(ABCA1)in predicting hemorrhagic transformation(HT)after thrombolysis and their relationship with short term prognosis in patients with acute ischemic stroke(AIS).Methods From January 2021 to Octo-ber 2023,185 patients with AIS who received intravenous thrombolysis in the Department of Neurology,First Affliated Hos-pital of Air Force Medical University(AIS group)and 100 healthy subjects(control group)were selected.AIS patients were divided into HT subgroup(56 cases)and non-HT subgroup(129 cases)according to whether HT occurred after thromboly-sis.According to the modified Rankin scale(mRS)at 3 months after thrombolysis,AIS patients were divided into poor prog-nosis subgroup(47 cases)and good prognosis subgroup(138 cases).Serum TSG-6 and ABCA1 levels were detected by en-zyme linked immunosorbent assay.Multivariate Logistic regression analysis was used to analyze the factors of HT after thrombolysis in AIS patients.Pearson method and ROC curve were used to analyze the correlation between serum TSG-6,ABCA1 levels and mRS score of AIS patients and their predictive value for HT after thrombolysis in AIS patients.Results Compared with the control group,the serum TSG-6 level in the AIS group increased and the ABCA1 level decreased(t/P=12.178/＜0.001,25.944/＜0.001).The incidence of HT in 185 AIS patients after thrombolysis was 3027％ (56/185).Com-pared with the non-HT subgroup,the serum TSG-6 level was increased and the ABCA1 level was decreased in the HT sub-group(t/P=7.607/＜0.001,6.784/＜0.001).After 3 months of follow up,the incidence of poor prognosis after thrombolysis in 185 AIS patients was 25.41％ (47/185).Compared with the good prognosis subgroup,the serum TSG-6 level was increased and the ABCA1 level was decreased in the poor prognosis subgroup(t/P=6.876/＜0.001,6.470/＜0.001).The mRS score of AIS patients was positively correlated with serum TSG-6 level and negatively correlated with ABCA1 level(r/P=0.693/＜0.001,-0.671/＜0.001).Increased National Institutes of Health Stroke Scale score,cardiogenic embolism,and elevated TSG6 were independent risk factors for HT in AIS patients after thrombolysis,and elevated ABCA1 was a protective factor[OR(95％ CI)=1.071(1.023-1.121),2.907(1.077-7.845),2.075(1.466-2.938),0.900(0.858-0.945)].The AUC of serum TSG-6,ABCA1 levels and the combination of the two in predicting HT after thrombolysis in AIS patients were 0.802,0.786 and 0.880,respec-tively.The AUC of the combination of the two was greater than that of serum TSG-6 and ABCA1 levels alone(Z/P=3.161/0.002,3 298/0.001).Conclusion The increase of serum TSG-6 level and the decrease of ABCA1 level in AIS patients are related to the occurrence of HT and poor short term prognosis.The combination of serum TSG-6 and ABCA1 levels has a higher predictive value for HT after thrombolysis in AIS patients.
关键词
急性缺血性脑卒中/肿瘤坏死因子α刺激基因6/ATP结合盒亚家族A成员1/出血转化/短期预后
Key words
Acute ischemic stroke/Tumor necrosis factor alpha stimulated gene 6/Adenosine triphosphate bind-ing cassette subfamily A member 1/Hemorrhagic transformation/Short term prognosis
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