The relationship between the expression of serum NSE and PTX3 and the recovery of neurological function in patients with ischemic stroke after intravenous thrombolysis with alteplase
Objective To observe the expression of serum neuron-specific enolase(NSE)and pentraxin 3(PTX3)and neurological recovery in patients with ischemic stroke,and to analyse the relationship between the expression of se-rum NSE and PTX3 and neurological recovery,with the aim of providing a target point of reference to clinically pro-mote the recovery of neurological function in patients.Methods Ischemic stroke patients admitted between January 2023 and January 2024 were included in the study,and all of them underwent thrombolytic treatment with alteplase,and the expression of serum NSE and PTX3 before thrombolysis was detected,and the neurological recovery of elderly pa-tients was evaluated according to the score of the National Institutes of Health Stroke Scale(NIHSS),and patients with≥45％decrease in NIHSS score after thrombolysis were included in the study.Compared with pre-thrombolysis,pa-tients with ≥45％reduction in NIHSS score after thrombolysis were included in the good recovery group,and those with＜45％reduction in NIHSS score were included in the poor recovery group,and the relationship between serum NSE,PTX3 expression and neurological recovery was analysed.Results After thrombolytic treatment with alteplase in 100 ischaemic stroke patients enrolled,62 cases were basically cured,10 cases were significantly effective,and the above 72patients were included in the good recovery group,15 cases were effective,13 cases were unchanged,and 28 patients were included in the poor recovery group.Compared with the poor recovery group,patients in the good recovery group had lower serum PTX3 and NSE expression and lower NIHSS scale scores,and the differences were statistically signifi-cant(P＜0.05);the results of the multivariate logistic regression model showed that the expression of serum PTX3 and NSE prior to thrombolysis was related to the recovery of neurological function after thrombolysis,and that the overex-pression of serum PTX3 and NSE might be the cause of ischaemic stroke.is a risk factor for poor neurological recovery after thrombolysis with alteplase in patients with ischemic stroke(OR＞1,P＜0.05);ROC curves were plotted,and the results showed that the AUCs of pre-thrombolysis serum PTX3 and NSE expression alone and in combination predicted the poor neurological recovery after thrombolysis in patients with ischemic stroke were both＞0.80,and the combined predictive value was more desirable.According to the ROC curve,the risk of poor neurological recovery after thrombol-ysis in ischemic stroke patients was higher when the pre-thrombolysis serum PTX3≥1.565(μg/L)and NSE≥27.160(μg/L);correlation analysis showed that the pre-thrombolysis serum PTX3 and NSE expression in ischemic stroke pa-tients were positively correlated with the post-thrombolysis NIHSS(P＜0.05).Conclusion Serum PTX3 and NSE ex-pression before thrombolysis by alteplase in ischemic stroke patients is closely related to the recovery of neurological function after thrombolysis,and overexpression of serum PTX3 and NSE before thrombolysis may be a risk factor lead-ing to poor neurological function recovery after thrombolysis in patients.
万方数据
维普
