1.Correlation and predictive value analysis of serum antithrombin Ⅲ,lactate dehydrogenase and procalcitonin with the efficacy of thrombolytic therapy for cerebral infarction
Ninghan CHU ; Peng WANG ; Jian ZHAO
Journal of Clinical Neurology 2024;37(6):422-427
Objective To explore the correlation and predictive value of serum antithrombin Ⅲ(TAT),lactate dehydrogenase(LDH),procalcitonin(PCT)with the efficacy of thrombolytic therapy for cerebral infarction.Methods A total of 140 patients with cerebral infarction who visited our hospital from May 2021 to April 2023 were collected.All patients received intravenous thrombolysis treatment,and the thrombolysis effect was evaluated by the NIHSS.Based on the thrombolysis effect,the patients were grouped into the poor thrombolysis effect group and the good thrombolysis effect group.Fasting venous blood was collected from patients at admission,24 h of treatment and 5 d of treatment,and serum levels of TAT,LDH,and PCT were detected by ELISA.Pearson and Spearman methods were applied to analyze the correlation between serum TAT,LDH and PCT in patients at 5 d after treatment with poor thrombolysis efficacy,and the correlation between the three items and the NIHSS score reduction rate,respectively.ROC curve was applied to analyze the diagnostic value of serum TAT,LDH,and PCT for poor thrombolysis efficacy.Logistic regression was applied to analyze the factors that affected the poor thrombolysis effect.Results Serum levels of TAT,LDH,and PCT were significantly lower in patients with cerebral infarction at 24 h and 5 d after treatment compared with patients before treatment,and serum levels of TAT,LDH,and PCT were significantly lower in patients with cerebral infarction at 5 d after treatment compared with patients at 24 h after treatment(all P<0.05).Compared with those in the good thrombolysis effect group,the NIHSS score reduction rate was obviously reduced in the poor thrombolysis effect group,and serum TAT,LDH,and PCT were obviously increased(all P<0.05).The serum TAT in the poor thrombolysis effect group showed a positive correlation with LDH and PCT,while the serum LDH and PCT showed a positive correlation.Spearman analysis showed that there was a negative correlation between serum TAT,LDH,PCT,and NIHSS score reduction rate in patients with poor thrombolysis effect.The area under the curve of serum TAT,LDH,PCT and their combination in diagnosing poor efficacy in thrombolytic therapy for cerebral infarction was 0.863,0.833,0.833 and 0.919,respectively,and the combination of the three was superior to their respective individual diagnoses(Z=1.976,Z=3.365,Z=2.946;P=0.048,P=0.000,P=0.003);serum TAT,LDH,PCT and NIHSS score reduction rate were independent influencing factors for poor efficacy of thrombolytic therapy for cerebral infarction(all P<0.05).Conclusions The high expression of serum TAT,LDH and PCT may be related to the poor efficacy of thrombolytic therapy for cerebral infarction,and has certain predictive value for the effectiveness of thrombolytic therapy.The combined diagnostic efficacy of the three factors is increased.
2.Analysis on correlation between serum levels of TAT,t-PAIC,TM and the progress of intracranial atherosclerotic stenosis
Peng WANG ; Chunhe ZHANG ; Jian ZHAO ; Ninghan CHU ; Xinzhe LYU ; Lin ZHANG ; Danlei WU ; Ruiju ZUO ; Rui ZHANG
Chinese Journal of Arteriosclerosis 2024;32(3):243-248
Aim To investigate the serum levels of thrombin-antithrombin complex(TAT),tissue type plas-minogen activator-inhibitor complex(t-PAIC)and thrombomodulin(TM)in patients with intracranial atherosclerotic steno-sis(ICAS),and their correlations with the degree of stenosis.Methods A total of 196 ICAS patients(ICAS group)who underwent treatment in Cangzhou People's Hospital from January 2021 to February 2023 were enrolled as research sub-jects.Based on the degree of vascular stenosis,they were separated into three groups:mild group(n=78),moderate group(n.=64),and severe group(n=54).A group of 196 healthy outpatient with similar clinical basic data to ICAS patients was selected as controls.The serum levels of TAT,t-PAIC,and TM in each group were compared;Spearman method was applied to analyze the correlation between serum levels of TAT,t-PAIC,TM and stenosis severity in ICAS pa-tients;Multivariate Logistic regression was applied to analyze the influencing factors of severe stenosis in ICAS patients;ROC curve was applied to analyze the predictive value of serum TAT,t-PAIC,TM and total cholesterol(TC)levels for se-vere stenosis in ICAS patients.Results Compared with the control group,the serum levels of TAT,t-PAIC,and TM were significantly increased in the ICAS group(P<0.05);the levels of serum TAT,t-PAIC,TM,and TC in the mild,moderate,and severe groups increased accordingly(P<0.05).Spearman analysis showed that the serum levels of TAT,t-PAIC,and TM in ICAS patients were positively correlated with the degree of stenosis(r=0.574,0.695,0.628;all P<0.05).Multivariate Logistic regression analysis showed that TAT,t-PAIC,TM,and TC were independent risk factors for severe stenosis in ICAS patients(P<0.05).The ROC curve showed that the AUC of severe stenosis in ICAS patients predicted by combination of TAT,t-PAIC,TM,and TC was 0.927,with a sensitivity of 83.33%and a specificity of 86.62%,which was superior to the independent prediction of TAT,t-PAIC,TM and TC(Zcombined detection-TAT=4.617,Zcombined deteetion-t-PAIC=4.024,Zcombined detection-TM=4.004,Zcombined detection-TC=7.078,all P=0.000).Conclusion The ser-um levels of TAT,t-PAIC,and TM in the ICAS group were significantly increased,and were positively correlated with the severity of stenosis.The combination of the three and TC has a high predictive value for the occurrence of severe stenosis in ICAS patients.
3.Correlation and predictive value analysis of serum antithrombin Ⅲ,lactate dehydrogenase and procalcitonin with the efficacy of thrombolytic therapy for cerebral infarction
Ninghan CHU ; Peng WANG ; Jian ZHAO
Journal of Clinical Neurology 2024;37(6):422-427
Objective To explore the correlation and predictive value of serum antithrombin Ⅲ(TAT),lactate dehydrogenase(LDH),procalcitonin(PCT)with the efficacy of thrombolytic therapy for cerebral infarction.Methods A total of 140 patients with cerebral infarction who visited our hospital from May 2021 to April 2023 were collected.All patients received intravenous thrombolysis treatment,and the thrombolysis effect was evaluated by the NIHSS.Based on the thrombolysis effect,the patients were grouped into the poor thrombolysis effect group and the good thrombolysis effect group.Fasting venous blood was collected from patients at admission,24 h of treatment and 5 d of treatment,and serum levels of TAT,LDH,and PCT were detected by ELISA.Pearson and Spearman methods were applied to analyze the correlation between serum TAT,LDH and PCT in patients at 5 d after treatment with poor thrombolysis efficacy,and the correlation between the three items and the NIHSS score reduction rate,respectively.ROC curve was applied to analyze the diagnostic value of serum TAT,LDH,and PCT for poor thrombolysis efficacy.Logistic regression was applied to analyze the factors that affected the poor thrombolysis effect.Results Serum levels of TAT,LDH,and PCT were significantly lower in patients with cerebral infarction at 24 h and 5 d after treatment compared with patients before treatment,and serum levels of TAT,LDH,and PCT were significantly lower in patients with cerebral infarction at 5 d after treatment compared with patients at 24 h after treatment(all P<0.05).Compared with those in the good thrombolysis effect group,the NIHSS score reduction rate was obviously reduced in the poor thrombolysis effect group,and serum TAT,LDH,and PCT were obviously increased(all P<0.05).The serum TAT in the poor thrombolysis effect group showed a positive correlation with LDH and PCT,while the serum LDH and PCT showed a positive correlation.Spearman analysis showed that there was a negative correlation between serum TAT,LDH,PCT,and NIHSS score reduction rate in patients with poor thrombolysis effect.The area under the curve of serum TAT,LDH,PCT and their combination in diagnosing poor efficacy in thrombolytic therapy for cerebral infarction was 0.863,0.833,0.833 and 0.919,respectively,and the combination of the three was superior to their respective individual diagnoses(Z=1.976,Z=3.365,Z=2.946;P=0.048,P=0.000,P=0.003);serum TAT,LDH,PCT and NIHSS score reduction rate were independent influencing factors for poor efficacy of thrombolytic therapy for cerebral infarction(all P<0.05).Conclusions The high expression of serum TAT,LDH and PCT may be related to the poor efficacy of thrombolytic therapy for cerebral infarction,and has certain predictive value for the effectiveness of thrombolytic therapy.The combined diagnostic efficacy of the three factors is increased.

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