The Relationship Between The VWF、IL-1β Gene Polymorphisms And The Efficacy Of Intravenous Thrombolysis With Rt-PA In Acute Ischemic Stroke

Objectives To investigate the factors affecting on efficacy of intravenous thrombolysis with rt‐PA and influence of vWF、IL‐1β gene polymorphisms on the clinical efficacy of intravenous thrombolysis with rt‐PA.Methods The clinical data of 96 acute ischemic stroke patients treated by intravenous thrombolysis with rt‐PA were retrospectively analyzed, The patients were divided into early effective group and ineffective group、hemorrhagic transformation(HT) group and non‐HT group、good outcome group and poor outcome group,which assessed by National Institute of Health Stroke Scale(NIHSS) decreased ≥4points or not at 24hours、if or not HT at 36 hours and the modified Rankin scale score <2points or not at 90 days,We detected the frequency of vWF、IL‐1β by polymerase chain reaction and direct sequencing method,Univariate analysis and multivariate logistic regression analysis were used to determine the differences of clinical data and the vWF、IL‐1β gene polymorphisms between the two groups.Results The early effective group was good in 40.6%(39/96),HT 14.6%(14/96)and the m RS was good in 39.8%(37/93). Univariate analysis indicated that systolic blood pressure before intravenous thrombolysis, mean arterial blood pressure before intravenous thrombolysis, cholesterol, low density lipoprotein cholesterol, serum‐albumin, glycosylated hemoglobin, baseline serum glucose, homocysteine, the rs16944 AA genotype of IL‐1β gene were shown correlated significantly with early efficacy,baseline NIHSS scores, atrial fibrillation, the rs16944 allele frequency distribution of IL‐1β gene were shown correlated significantly with HT, Diabetes mellitus, atrial fibrillation,age, systolic blood pressure before intravenous thrombolysis, diastolic pressure before intravenous thrombolysis,mean arterial blood pressure before intravenous thrombolysis, baseline NIHSS scores, cholesterol,glycosylated hemoglobin were shown correlated significantly with good outcome(m RS).However the multivariate logistic regression analysis did select homocysteine, the rs16944 AA genotype of IL‐1β gene as the independent predictors of early efficacy, time from stroke onset to treatment, atrial fibrillation,the genotype of rs16944 as the independent predictors of HT and age,baseline NIHSS scores as the independent predictors of good outcome(m RS).Conclusions Homocysteine, the rs16944 AA genotype of IL‐1β gene should be independently predictive of early efficacy, time from stroke onset to treatment, atrial fibrillation, the genotype of rs16944 should be independently predictive of HT,and age, baseline NIHSS scores should be independently predictive of good outcome in patients with acute ischemic stroke treated by intravenous thrombolysis with rt‐PA.