| Objective:Acute ischemic stroke occupies the first in the global incidence of various cerebrovascular diseases,with an extremely high disability rate and mortality rate,which threatens the health of human.With the evidence of various diseases,PTX3 has been proved to be an effective index to evaluate the severity and prognosis of patients before and after thrombolysis.However,the value of PTX3 in cerebrovascular field remains to be further explored.Therefore,this article will investigate the changes of PTX3 in patients with acute cerebral infarction before and after thrombolysis,and analyze the correlation between PTX3 and thrombolytic efficacy as well as long-term prognosis.Methods:Prospectively recruited patients with acute ischemic stroke who were conducted with intravenous thrombolytic therapy from July 2016 to June 2017.All patients underwent multi-mode imaging evaluation and were proved that there were no indications for further endovascular treatment.Plasma samples of patients were collected before and after 24 hours of thrombolysis,and the concentration of PTX3 was determined by enzyme-linked immunosorbent assay.NIHSS scores of the patients were calculated before and after 24 hours of thrombolytic therapy.Demographic data,risk factors of stroke,treatment time-window of thrombolytic therapy(3/3-4.5hours),history of statin use were recorded;and mRS scores were performed 3 months later after the onset of the disease.The criterion that improvement of 24 hour NIHSS scores after thrombolytic therapy by 40% from baseline NIHSS scores before thrombolytic therapy was adopted as an effective criterion for thrombolytic therapy and mRS scores?2 were adopted as a criteria of good prognosis.The value of PTX3 in thrombolytic therapy was evaluated by comparing the related factors between the effective thrombolytic group and the ineffective thrombolytic group and by the subgroup analysis according to the tertiles of PTX3 levels before thrombolysis.Univariate and multivariate analysis was used to evaluate the correlation between PTX3 and thrombolytic efficacy as well as long-term prognosis.Results:A total of 47 patients(30 males and 17 females)with the age of 44-83 years old were enrolled in this study.There were 22 cases in thrombolytic efficacy group and 25 cases in thrombolytic inefficacy group,of which there was significant difference in thrombolytic therapy within 3 hours(P=0.03)and 24-hour NIHSS score(P<0.001).The concentration of PTX3 in the thrombolytic efficacy group was higher than that in the thrombolytic inefficacy group before and after 24 hours of thrombolysis,but there was no statistically significant differences between the two groups(P=0.72,P=0.36).By subgroup analysis of PTX3 before thrombolytic therapy,there was no significant difference in demography,risk factors of stroke and treatment time-window.Univariate and multivariate analysis were conducted for the improvement of nerve function after thrombolysis and PTX3 before and after 24 hours of thrombolysis were not associated with the thrombolytic efficacy.The univariate and multivariate analysis of MRS scores after 3 months showed no correlation between PTX3 before thrombolysis and the good prognosis.Conclusion:In this study,neurological improvement at 24 hours after thrombolytic therapy was related with the treatment time-window in patients with acute ischemic stroke who received thrombolytic therapy.It is not yet to be convinced that PTX3 levels were associated with the neurological improvement at 24 hours after thrombolytic therapy and the long prognosis whether the PTX3 levels were measured before or after thrombolytic therapy... |
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