急性脑梗死患者同型半胱氨酸血小板相关参数与急诊介入溶栓后临床结局的关系

doi:10.3969/j.issn.1006-6233.2025.06.07

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Abstract Objective: To observe the relationship between changes of serum homocysteine (Hcy) and platelet-related parameters and clinical outcomes after emergency interventional thrombolysis in patients with acute cerebral infarction (ACI). Methods: Totally 116 patients with ACI in the hospital were included from August 2022 to June 2024. All enrolled patients received emergency interventional thrombolytic therapy. The changes of serum Hcy and platelet-related parameters [platelet count (PLT), membrane glycoprotein p-selectin (P-selection, CD62P), platelet distribution width (PDW)] were observed before intervention, and the relationship with clinical outcomes of patients was analyzed. Results: The levels of Hcy, CD62P and PDW in patients with poor prognosis were higher than those in patients with good prognosis (P<0.05) while the PLT level was lower than that in patients with good prognosis (P<0.05). Spearman correlation analysis indicated that Hcy, CD62P and PDW were positively correlated with modified Rankin scale (mRS) score (r=4.766, 3.862, 4.268, P<0.05), and PLT level was negatively correlated with mRS score (r=-3.984, P<0.05). Univariate analysis revealed that diabetes mellitus, age, time from onset to admission, and National Institutes of Health Stroke Scale (NIHSS) score were associated with clinical outcomes of ACI patients (P<0.05). Logistic regression analysis found that diabetes mellitus, age, time from onset to admission, NIHSS score, Hcy, CD62P and PDW were risk factors affecting the clinical outcomes of patients (P<0.05), and PLT level was a protective factor (P<0.05). ROC curve demonstrated that the AUCs of Hcy, PLT, CD62P and PDW in evaluating the clinical outcomes were 0.816, 0.744, 0.732 and 0.804 respectively. Conclusion: The abnormal levels of Hcy, PLT, CD62P and PDW are related to clinical outcomes of ACI patients with emergency interventional thrombolysis, and have certain evaluated value.

Key words： Acute cerebral infarction Interventional thrombolysis Homocysteine Prognosis Predictive value

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.06.07 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I6/912

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