Relationship between estimated glomerular filtration rate, serum uric acid, fibrinogen and cerebral hemorrhage transformation after thrombolysis in ischemic stroke and its predictive value for outcome
Author:
Affiliation:

1.Department of Neurology, No. 990 Hospital of Joint Service Support Force of Chinese People's Liberation Army, Xinyang, Henan 464000, China;2.First Department of Neurology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China)

Clc Number:

R743

  • Article
  • | |
  • Metrics
  • |
  • Reference [23]
  • | | | |
  • Comments
    Abstract:

    Aim To investigate the relationship between estimated glomerular filtration rate (EGFR), serum uric acid (SUA), fibrinogen (FIB) and cerebral hemorrhage transformation and clinical outcome after thrombolysis in ischemic stroke. Methods 158 patients with ischemic stroke treated with recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis were selected, including 121 cases without cerebral hemorrhage transformation and 37 cases with cerebral hemorrhage transformation. Logistic regression equation was used to analyze the influencing factors of cerebral hemorrhage transformation after intravenous thrombolysis with rt-PA. The levels of eGFR, SUA and FIB were compared in patients with different early neurological function. The predictive values of eGFR, SUA and FIB for early neurological deterioration (END) were evaluated. The cumulative survival rates of patients with different levels of eGFR, SUA and FIB were compared. Results After intravenous thrombolysis with rt-PA for 2 h and 24 h, the levels of eGFR, SUA and FIB in patients with cerebral hemorrhage transformation were lower than those without cerebral hemorrhage transformation (P<0.05). Logistic regression analysis showed that age, baseline NIHSS score, baseline diastolic blood pressure, large-area cerebral infarction, levels of eGFR, SUA and FIB at 2 h and 24 h after thrombolysis were the influencing factors of cerebral hemorrhage transformation after rt-PA intravenous thrombolysis (P<0.05). eGFR, SUA and FIB in END patients were lower than those in non-END patients at 2 h and 24 h after thrombolysis (P<0.05). ROC curve analysis showed that the area under curve for the joint predicting END by 24 h eGFR, 24 h SUA and 24 h FIB was 0.809, which was greater than any single index, and its sensitivity and specificity were 80.95% and 74.14% respectively. The results of survival analysis showed that the cumulative survival rate of high-level eGFR, SUA and FIB group was higher than that of low-level group 24 h after thrombolysis (P<0.05). Conclusion eGFR, SUA, FIB are closely related to the prognosis of ischemic stroke. Monitoring the above indicators is helpful for the diagnosis of cerebral hemorrhage transformation and END prediction.

    Reference
    [1] CAMEN S, HAEUSLER K G, SCHNABEL R B.Cardiac imaging after ischemic stroke or transient ischemic attack.Curr Neurol Neurosci Rep, 0,0(8):36.
    [2] 董漪, 董强.中国急性缺血性卒中静脉溶栓现状.中国实用内科杂志, 8,8(8):685-688.
    [3] BEATO-COELHO J, VARELA R, ALMENDRA L, et al.Ischemic stroke incidence in patients with microvascular ocular motor palsy versus patients with lacunar ischemic stroke.Neurologist, 9,4(2):50-52.
    [4] 李超英, 刘福达, 温骏, 等.血压波动对rt-PA静脉溶栓后出血转化及预后的影响研究.赣南医学院学报, 0,0(3):58-60.
    [5] 何子龙, 马国重, 崔芳.rt-PA静脉溶栓后颅内出血转化相关机制的研究进展.神经疾病与精神卫生, 7,7(3):222-225.
    [6] 李培育, 王秀萍.脑出血患者血清Hcy、hs-CRP、DD、FIB变化及临床意义.医学信息, 7,0(12):44-45.
    [7] DAHAL K, KUNWAR S, RIJAL J, et al.Stroke, major bleeding, and mortality outcomes in warfarin users with atrial fibrillation and chronic kidney disease:a Meta-analysis of observational studies.Chest, 6,9(4):951-959.
    [8] 张爱玲, 许珂, 邢海英, 等.心肾功能对急性脑卒中早期神经功能恢复的影响.中华神经科杂志, 9,2(6):463-471.
    [9] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018.中华神经科杂志, 8,1(9):666-682.
    [10] NEUBERGER U, MHLENBRUCH M A, HERWEH C, et al.Classification of bleeding events:comparison of ECASS Ⅲ (European cooperative acute stroke study) and the new heidelberg bleeding classification.Stroke, 7,8(7):1983-1985.
    [11] 邱凯, 施海彬, 祖庆泉, 等.机械取栓治疗院内外急性缺血性脑卒中疗效的倾向性匹配研究.中华放射学杂志, 0,4(4):360-363.
    [12] 景黎君, 杨静尘, 杨伟民.进展性缺血性脑卒中研究现状.华西医学, 0,5(6):20-25.
    [13] NATSUAKI M, MORIMOTO T, WATANABE H, et al.Ischemic and bleeding risk after percutaneous coronary intervention in patients with prior ischemic and hemorrhagic stroke.J Am Heart Assoc, 9,8(22):e013356.
    [14] SNARSKA K, KAPICA-TOPCZEWSKA K, BACHRZEWSKA-GAJEWSKA H, et al.Renal function predicts outcomes in patients with ischaemic stroke and haemorrhagic stroke.Kidney Blood Press Res, 6,1(4):424-433.
    [15] 裴洪菲, 佟旭, 于萍, 等.估算肾小球滤过率对急性缺血性卒中患者重组组织型纤溶酶原激活剂静脉溶栓结局的预测价值.中华神经科杂志, 8,1(4):268-274.
    [16] 刘梅.2型糖尿病合并冠心病患者血浆纤维蛋白原、D二聚体及脂蛋白a水平的临床分析.中南医学科学杂志, 9,7(2):192-194.
    [17] 史丹丹, 汪国爱.血清Fib与pro-BNP联合测定在老年高血压脑出血后脑水肿患者神经功能损伤中的预测价值.浙江中西医结合杂志, 8,8(4):290-292.
    [18] 胡超勇, 邹华伟, 高鹏芝.急性心梗后心功能预后与血尿酸及肌酸肌酶同工酶水平的相关性.分子诊断与治疗杂志, 0,2(10):1415-1418.
    [19] SHI X, YANG J, WANG L, et al.Prospective study of serum uric acid levels and stroke in a Chinese hypertensive cohort.Clin Exp Hypertens, 7,9(6):527-531.
    [20] 方传勤, 何晓璐, 戴鸣, 等.脑动脉粥样硬化性狭窄与急性大动脉粥样硬化性卒中患者早期神经功能恶化的相关性.国际脑血管病杂志, 9,7(1):6.
    [21] 邓云凌, 黎祺, 杨春晓.腔隙性卒中患者的早期神经功能恶化:病理生理学机制和预测因素.国际脑血管病杂志, 8,6(4):303-306.
    [22] 张怡, 张敏, 恽文伟, 等.肾小球滤过率对急性大脑中动脉梗死患者肢体运动功能康复及短期预后的影响.中华神经医学杂志, 9,8(11):1109-1115.
    [23] SONG C, ZHAO X.Uric acid promotes oxidative stress and enhances vascular endothelial cell apoptosis in rats with middle cerebral artery occlusion.Biosci Rep, 8,8(3):BSR20170939.
    Related
    Cited by
    Comments
    Comments
    分享到微博
    Submit
Get Citation

LIU Wenke, YANG Xiaopeng. Relationship between estimated glomerular filtration rate, serum uric acid, fibrinogen and cerebral hemorrhage transformation after thrombolysis in ischemic stroke and its predictive value for outcome[J]. Editorial Office of Chinese Journal of Arteriosclerosis,2022,30(3):248-254.

Copy
Share
Article Metrics
  • Abstract:874
  • PDF: 816
  • HTML: 0
  • Cited by: 0
History
  • Received:April 09,2021
  • Revised:June 16,2021
  • Online: January 14,2022
Article QR Code