Objective To explore the association between serum apolipoprotein A1 (Apo-A1) and vascular reocclusion after intravenous thrombolysis in patients with acute cerebral infarction, and constructing a risk prediction model. Methods 81 patients with acute cerebral infarction who experienced vascular re occlusion after intravenous thrombolysis and were treated in our hospital from January 2019 to December 2023 were selected as the observation group, while 162 patients with acute cerebral infarction who did not experience vascular re occlusion after intravenous thrombolysis were selected as the control group. The differences in clinical data between the two groups were compared, and the correlation between Apo-A1 and the National Institutes of Health Stroke Scale score (NIHSS) before thrombolysis was analyzed, as well as the construction of a risk prediction model for vascular re occlusion after intravenous thrombolysis. Results The observation group and the control group were compared in terms of the time from onset to thrombolysis, NIHSS score before thrombolysis, D-D before thrombolysis, Apo-A1 before thrombolysis, and infarct diameter, the differences were statistically significant. There was a negative correlation between pre thrombolysis Apo-A1 and pre thrombolysis NIHSS score (r=-0.755, P<0.05). Logistic regression analysis showed that long onset to thrombolysis time, high NIHSS score before thrombolysis, high D-Dimer (D-D) level before thrombolysis, low ApoA1 level before thrombolysis, and infarct diameter>3 cm were risk factors for vascular reocclusion after intravenous thrombolysis, logistic regression model was used to construct a column chart model, ROC curve analysis showed that the area under the curve of the column chart model was 0.860 (95% CI: 0.790-0.931), sensitivity and specificity were 88.00%(95% CI: 0.823-0.934) and 74.00%(95% CI: 0.698-0.843), respectively. Conclusion Apo-A1 is negatively correlated with the NIHSS score before intravenous thrombolysis in patients with acute cerebral infarction, and maybe a influencing factor for vascular re occlusion after intravenous thrombolysis in patients with acute cerebral infarction, is one of the parameters for constructing a risk prediction model.
Key words
serum apolipoprotein A1 /
acute cerebral infarction /
intravenous thrombolysis /
reocclusion of blood vessels /
risk prediction model
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References
[1] HUO X, MA G, TONG X, et al.Trial of Endovascular Therapy for Acute Ischemic Stroke with Large Infarct[J]. N Engl J Med, 2023, 388(14): 1272-1283.
[2] GAO L, ZHANG S, WO X, et al.Intravenous thrombolysis with alteplase in the treatment of acute cerebral infarction[J]. Pak J Med Sci, 2022, 38(3): 498-504.
[3] WANG Z, CHE J.Effectiveness of alteplase intravenous thrombolysis combined with butylphthalide in patients with acute severe cerebral infarction[J]. Folia Neuropathol, 2022, 60(4): 421-426.
[4] ZHOU X, YANG J, LIU L, et al.Clinical Effect of Butylphthalide Combined with Rt-PA Intravenous Thrombolysis in the Treatment of Acute Cerebral Infarction[J]. Appl Bionics Biomech, 2022, 32(8): e9215685.
[5] LIU L, LUO GQ, LIU Q, et al.Hemorrhagic risk factors after rt PA thrombolysis in acute cerebral infarction[J]. Eur Rev Med Pharmacol Sci, 2023, 27(12): 5542-5551.
[6] WU H, GONG W, TANG Y, et al.Meta-Analysis of the Effectiveness and Safety of Intravenous Thrombolysis in Patients with Acute Cerebral Infarction[J]. Comput Math Methods Med, 2021, 12(8): e2833043.
[7] JANG J, LEE JK, KOO J, et al.Acute Ischemic Stroke Caused by Internal Carotid Artery Occlusion: Impact of Occlusion Type on the Prognosis[J]. World Neurosurg, 2022, 164(8): e387-e396.
[8] HAIYONG Z, WENCAI L, YUNXIANG Z, et al.Construction of a Nomogram Prediction Model for Prognosis in Patients with Large Artery Occlusion-Acute Ischemic Stroke[J]. World Neurosurg, 2023, 172(8): e39-e51.
[9] 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南2010[J]. 中国临床医生, 2011, 2(3): 50-59.
[10] 胡卫绵, 高文勇, 韩英. 老年急性脑梗死患者溶栓治疗后发生血管再闭塞的影响因素[J]. 中国老年学杂志, 2023, 43(17): 4114-4116.
[11] KWAH LK, DIONG J.National Institutes of Health Stroke Scale (NIHSS)[J]. J Physiother, 2014, 60(1): 61-63.
[12] ZHENG H, ZHENG B, YANG S, et al.Effect of intravenous thrombolysis combined with endovascular treatment on vascular recanalization rate and peak systolic velocity in patients with acute cerebral infarction[J]. Pak J Med Sci, 2023, 39(5): 1291-1295.
[13] LIU Y, HONG Z, LI Y, et al.Effect of intravenous thrombolysis combined with mechanical thrombectomy on neurological function and short-term prognosis of patients with acute cerebral infarction[J]. Am J Transl Res, 2022, 14(4): 2376-2382.
[14] ZHANG L, ZHAO J, KAN B, et al.Factors associated with early neurological deterioration after intravenous thrombolysis in acute cerebral infarction patients and establishment of a predictive model[J]. Am J Transl Res, 2025, 17(1): 247-253.
[15] HUO J, LI W, LIU Y.Intravenous Thrombolysis Combined with Arterial Thrombolysis (Bridging Therapy) Effectively Improves Vascular Recanalization Rate in Patients with Cerebral Infarction[J]. J Immunol Res, 2022, 24(8): e8295212.
[16] GIBSON CM, KASTELEIN JJP, PHILLIPS AT, et al.Rationale and design of ApoA-I Event Reducing in Ischemic Syndromes II (AEGIS-II): A phase 3, multicenter, double-blind, randomized, placebo-controlled, parallel-group study to investigate the efficacy and safety of CSL112 in subjects after acute myocardial infarction[J]. Am Heart J, 2021, 231(6): 121-127.
[17] JUNG HW, HONG SP, KIM KS.Comparison of apolipoprotein B/A1 ratio, TC/HDL-C, and lipoprotein (a) for predicting outcomes after PCI[J]. PLoS One, 2021, 16(7): e0254677.
[18] SCOPELLITI G, KARAM A, LABREUCHE J, et al.Internal carotid artery patency after mechanical thrombectomy for stroke due to occlusive dissection: Impact on outcome[J]. Eur Stroke J, 2023, 8(1): 199-207.
[19] JIN M, PENG Q, WANG Y.Post-thrombolysis early neurological deterioration occurs with or without hemorrhagic transformation in acute cerebral infarction: risk factors, prediction model and prognosis[J]. Heliyon, 2023, 9(5): e15620.
[20] 周正, 黄欣欣, 刘源, 等. 缺血性脑卒中严重程度相关的生化指标分析[J]. 中国医药科学, 2023,13(019):152-156.
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