Zhongguo linchuang yanjiu (Nov 2023)
Relationship between rLMC score, peripheral blood ACE, SDF-1α and prognosis of acute anterior circulation cerebral infarction after intravenous thrombolysis
Abstract
Objective To explore the relationship between regional leptomeningeal collateral (rLMC) score, peripheral blood angiotensin-converting enzyme (ACE), matrix-derived growth factor (SDF)-1α levels, and the prognosis of acute anterior circulation ischemic stroke (AACI) treated with intravenous thrombolysis. Methods A total of 117 patients with AACI admitted to Jinan Third People's Hospital from August 2018 to August 2022 were selected. Based on the modified Rankin Scale (mRS) score at 3 months after intravenous thrombolysis, patients were divided into good prognosis group (mRS score 0-1, n=70) and poor prognosis group (mRS score 2-5, n=47).The Clinical data, rLMC score, ACE, and SDF-1α were compared between the two groups. The correlation between rLMC score, ACE, SDF-1α, and the National Institutes of Health Stroke Scale (NIHSS) score at admission in AACI patients was analyzed. Logistic multivariate analysis was used to analyze the influencing factors on the prognosis of AACI after intravenous thrombolysis, and the predictive efficacy of each indicator for the prognosis of AACI treated with intravenous thrombolysis was evaluated using receiver operating characteristic (ROC) curve. Results Multivariate logistic analysis showed that higher NIHSS score at admission, lower rLMC score, higher ACE level, and lower SDF-1α level were independent risk factors for poor prognosis of AACI after intravenous thrombolysis (P＜0.05). The rLMC score and SDF-1α level in the 117 AACI patients were negatively correlated with the NIHSS score at admission(r=－0.402，－0.577，P＜0.05), while ACE level was positively correlated with the NIHSS score at admission(r=0.357，P＜0.05). The combined use of rLMC score, ACE, and SDF-1α had the highest predictive efficacy for the prognosis of AACI treated with intravenous thrombolysis (AUC=0.824). Conclusion rLMC score, peripheral blood ACE, and SDF-1α levels are closely related to the prognosis of AACI after intravenous thrombolysis and may serve as predictive factors for unfavorable outcomes at three months.
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