Correlation of cerebral blood flow after thrombolysis with ischemia-reperfusion injury and neurological function in patients with AIS
10.3969/j.issn.1009-0126.2024.09.015
- VernacularTitle:急性缺血性脑卒中患者溶栓后脑血流量与缺血再灌注损伤及神经功能的相关性研究
- Author:
Chunqin LIU
1
;
Shuang TAN
Author Information
1. 063000 唐山市工人医院神经内科
- Keywords:
stroke;
thrombolytic therapy;
reperfusion injury;
cerebral blood flow
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(9):1049-1053
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the correlation of cerebral blood flow(CBF)after thrombolys-is with ischemia-reperfusion(I/R)injury and neurological function in patients with acute ischemic stroke(AIS).Methods Clinical data of 150 AIS patients admitted to our department from Febru-ary 2021 to February 2024 were collected and analyzed retrospectively.According to the changes in CBF in the affected side after thrombolysis,they were divided into hyperperfusion group(48 cases)and hypoperfusion group(102 cases).The condition of hemorrhagic transformation and perfusion parameters included CBF,cerebral blood volume(CBV),time to peak of residual func-tion(Tmax),mean transit time(MTT)and time to peak(TTP),and the relative values of regional cerebral blood flow(rCBF),rCBV,Tr,max,rMTT and rTTP.The general clinical data,oxidative stress,NIHSS score and inflammatory factor levels were compared between the two groups.Pear-son/Spearman correlation analysis was used to analyze the correlation between rCBF and oxida-tive stress,inflammatory factors,hemorrhagic transformation and NIHSS score in AIS patients after thrombolysis.Results In the hypoperfusion group,the MTT,Tmax and TTP values were sig-nificantly higher,and the CBF value was obviously lower in the affected side than the healthy side(P<0.01).In hyperperfusion group,the MTT and TTP were notably lower,while the CBF and CBV were remarkably higher in the affected side than the healthy side(P<0.01).The hypoperfu-sion group had significantly higher rMTT,Tr,max and rTTP,but lower rCBV and rCBF than the hyperperfusion group(P<0.01).The levels of malondialdehyde(MDA),advanced oxidation pro-tein products,TNF-α and C-reactive protein(CRP)were significantly lower,and the level of su-peroxide dismutase(SOD)was higher in the hypoperfusion group than the hyperperfusion group(P<0.05,P<0.01).Pearson correlation analysis showed that rCBF was negatively correlated with MDA and TNF-α(r=-0.436,r=-0.451,P<0.01)and positively correlated with SOD(r=0.412,P<0.01).Conclusion The CBF changes after thrombolysis in AIS patients have a good correlation with I/R injury,but not with the recovery of neurological function.