Association Of Serum Annexin A2 Level And Early Neurological Improvement In Thrombolytic Patient With Acute Ischemic Stroke

Objective:To investigate the relationship between the level of serum Annexin A2(A2)and early neurological improvement(ENI)after recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis in acute ischemic stroke(AIS).Methods:AIS patients undergoing rt-PA intravenous thrombolysis within 4.5 hours onset were recruited from the emergency department of neurology in Second Affiliated Hospital,Zhejiang University School of Medicine between August 2013 and April 2016.Demographics,clinical and laboratory data were collected from electronic medical record.Blood samples were collected before thrombolysis and stored at-80°C.The level of serum A2 was measured using ELISA.ENI was defined as a ?4-point decreasein NIHSS score compared with baseline or a score of 0 or 1 at 24 h,3 d and 7 d after rtPA thrombolysis.We compared the admission level of serum A2 in patients with or without ENI 24 h,3 d and 7 d after thrombolysis,and the relation between serum A2 level and ENI was analyzed by logistic regression.Results:Of the 64 cases,26 were female,with an average age of 68.89 ± 12.41,30 patients had ENI 7 days after rt-PA intravenous thrombolysis.Admission level of serum A2 were higher in ENI group compared with those without ENI 24 h,3 d and 7 d after thrombolysis,in which there was a significant difference between ENI and non ENI group(P = 0.021)7 d after thrombolysis.Logistic regression analysis found that admission serum A2 level were associated with ENI 7 d after rt-PA intravenous thrombolysis(adjusted OR = 1.070,95%Cl 1.007 ~ 1.138,P = 0.030).Conclusions:Admission level of serum A2 was associated with ENI 7 d after rt-PA intravenous thrombolysis,and was its independent risk factor.