The predictive value of serum neuron specific enolase and central nervous system specific protein levels for the outcome of recombinant tissue plasminogen activator intravenous thrombolysis in patients with acute ischemic stroke
Objective Exploring the predictive value of serum neuron specific enolase(NSE)and central nervous system specific protein(S100-β)for the outcomes of recombinant tissue plasminogen acti-vator(rt-PA)intravenous thrombolysis in patients with acute ischemic stroke(AIS).Methods Totally,156 patients with acute ischemic stroke admitted to Xin'an International Hospita and Nanshan Hospital in Shandong Province from January 2021 to December 2022 were selected as the research subjects,using rt-PA for intravenous thrombolysis treatment,peripheral blood NSE and S100-βwere measured before and after thrombolysis,respectively Expression level.On the 90th day after thrombolysis,the RanKin scale(mRS)was used to evaluate the recovery of neurological function.According to the mRS score,the selected pa-tients are divided into a good prognosis group and a poor prognosis group.The clinical data differences be-tween the two groups,as well as NSE and S100-β,are compared Expression level,and further use of mul-tiple regression analysis for NSE and S100-βthe predictive value of expression level on patient treatment prognosis.Results On the 90th day after intravenous thrombolysis,the patient was evaluated for mRS score.mRS score of ≤2 indicates a good prognosis,while an mRS score of 3-6 indicates a poor prognosis.Among them,62.18％(97 cases)in the good prognosis group was significantly higher than 37.82％(59 cases)in the poor prognosis group,P＜0.05.Comparison of clinical data between two groups of patients shows:The level of good prognosis group in age(Year),Blood glucose before thrombolysis(mmol/L),(National Institute of Health Stroke Scale,NIHSS)score(mmol/L)and hospital stay(d)before thromboly-sis was lower than that of poor prognosis group[(61.21±5.32,5.07±0.81,13.36±3.35 and 11.85± 3.7)compare to(66.75±5.03,5.92±1.86,17.46±4.16 and 19.2±5.76),t=18.125,15.237,11.163,P＜0.05];The good prognosis group was higher than the poor prognosis group in gender(Male/Female),triglyceride(mmol/L),blood pressure(mmHg)and stroke subtype(n)[41/56,3.31± 1.07,(admission systolic pressure 156.3±16.3,admission diastolic pressure 91.8±11.2)and(small artery occlusion type 30,cardiogenic embolism type 10,large atherosclerosis type 57)compare to 32/27,2.73±1.13,(admission systolic pressure 151.7±13.5,admission diastolic pressure 90.5±10.6)and(small artery occlusion type 20,cardiogenic embolism type 7,large atherosclerosis type 32),The t-values in sequence are 14.401,12.152,10.312,0.822,P＞0.05].Two groups of patients NSE and S100-βComparison of expression levels,good prognosis before thrombolysis group in NSE and S100-β The expres-sion level was significantly higher in the group with poor prognosis[(27.19±6.53),(25.13±5.17)ng/ml compared to(2.15±0.08),(1.79±0.09)ng/ml,t=14.315,11.217,8.534,P＜0.05];On the 90th day of thrombolysis,the group with good prognosis was significantly lower than the group with poor prognosis[(2.42±0.23),(2.05±0.17)ng/ml compared to(8.69±0.74),(9.25±0.58)ng/ml,t=7.431,4.652,respectively P＜0.05];The results of logistic regression analysis showed that high levels of NSE and S100-β before thrombolysis were protective factors for the prognosis of rt-PA intravenous thrombol-ysis in patients with acute ischemic stroke(OR=0.31,0.28,P＜0.05),Pre thrombolytic NIHSS score＞12 is a risk factor for the outcome of rt-PA intravenous thrombolysis in patients with acute ischemic stroke(OR=2.58,P＜0.05).Conclusion The Serum NSE and S100-β expression level can make early pre-dictions for patients with acute ischemic stroke,providing important reference value for early diagnosis and treatment of patients.
Acute ischemic strokeSerum neuron specific enolaseCentral nervous system specific proteins
NETL
NSTL
万方数据
