Association of Serum PTX3 Level with First-pass Effect and Prognosis of Mechanical Thrombectomy in Patients with Acute Ischemic Stroke of Large Vessel Occlusion
10.3969/j.issn.1671-7414.2024.04.020
- VernacularTitle:大血管闭塞型急性缺血性脑卒中患者血清PTX3水平与机械取栓首次通过效应及预后的相关性研究
- Author:
Yu HAO
1
;
Chao LIU
;
Yinguang CAO
;
Changyun LI
Author Information
1. 聊城市人民医院检验科,山东聊城 252000
- Keywords:
acute ischemic stroke;
pentraxin3;
mechanical thrombectomy;
first-pass effect
- From:
Journal of Modern Laboratory Medicine
2024;39(4):110-115
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between pentraxin 3(PTX3)and first-pass effect of mechanical thrombectomy in patients with large vessel occlusion acute ischemic stroke(AIS).Methods A total of 136 AIS patients with large vessel occlusion treated in Liaocheng People's Hospital from January to August 2023 were selected,and they were divided into first pass group(n=41)and non-first pass group(n=95)according to whether they achieved first-pass effect of mechanical thrombectomy.The clinical data of all patients were collected and the serum PTX3 levels were detected.All patients were followed up for 3 months,and the prognosis was evaluated according to the modified Rankin score.Multivariate Logistic regression was used to analyze the influencing factors of first-pass effect in AIS patients with large vessel occlusion.ROC analysis was used to analyze the predictive value of serum PTX3 for first-pass effect in AIS patients with large vessel occlusion.Results The rate of good prognosis in the first pass group was higher than that in the non-first pass group(56.10％vs 36.84％),and the difference was significant(x2=4.341,P=0.037).Compared with the non-first pass group,the age(59.38±5.12 years),the proportion of hypertension(43.90％),the National Institutes of Health Stroke Scale(NIHSS)score at admission(13.58±4.16 score)in the first pass group and serum PTX3 level(1.21±0.32 ng/L)in the first pass group were lower than those in the failed group(63.45±7.61 years,65.26％,15.75±5.13 score,1.71±0.41 ng/L),and the differences were significant(t/x2=3.129,5.395,2.389,6.944,all P＜0.05).Multivariate Logistic regression analysis showed that younger age[OR(95％CI):0.859(0.752～0.982)],no hypertension[OR(95％CI):0.672(0.480～0.942)],decreased NIHSS score at admission[OR(95％CI):0.867(0.781～0.962)]and decreased serum PTX3 levels[OR(95％CI):0.558(0.326～0.954)]were the influencing factors of the first-pass effect of mechanical thrombectomy in AIS patients with large vessel occlusion(Waldx2=4.997,5.238,7.280,4.543,all P＜0.05).After 3 months of follow-up,the serum PTX3 level of the good prognosis group was lower than that of the poor prognosis group(1.28±0.39 ng/L vs 1.65±0.43 ng/L),and the difference was significant(t=5.111,P＜0.001).ROC analysis showed that serum PTX3 had a high predictive value for first-pass effect and poor prognosis in AIS patients with large vessel occlusion,with the areas under the curve(95％CI)of 0.785(0.703～0.866)and 0.734(0.651～0.806),respectively,and their optimal cut-off values were 1.38 ng/L and 1.56 ng/L,respectively.Conclusion The first-pass effect of mechanical thrombectomy in AIS patients with large vessel occlusion is beneficial to the short-term prognosis.The expression of serum PTX3 is closely related to the first-pass effect in AIS patients with large vessel occlusion,and this index could have a high predictive value for whether the patients can achieve the first-pass effect.
