血清HGF水平对急性缺血性脑卒中患者行rt-PA静脉溶栓治疗结局的预测价值分析

摘要

Objective To study the value of serum hepatocyte growth factor (HGF) level in the prediction of outcomes of intravenous thrombolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) for patients with acute ischemic stroke.Methods 52 patients with acute ischemic stroke treated at our hospital from May,2016 to September,2017 were selected as study objects,and were treated with intravenous thrombolytic therapy with rt-PA.The level of HGF in peripheral blood were detected before and after the treatment.The mRS score was performed in the third month after the thrombolysis.The patients were divided into a good outcome group and an adverse outcome group according to the mRS score.The levels of HGF and the differences of general data of different outcomes were compared.The value of HGF level in predicting the treatment outcome was further analyzed using binary regression analysis.Results Three months after the thrombolysis,the patients were assessed with mRS score,and the good outcome rate was 66.07％ (37 cases).The general data of the two groups showed that there were statistical differences in age and NIHSS score before thrombolysis and hospitalization time between the two groups (both P ＜ 0.05),but no in gender,BMI,previous disease history,blood pressure,triglyceride,and stroke subtype (all P ＞ 0.05).The level was higher before but lower after thrombolysis in the good outcome group than in the adverse outcome group (P ＜ 0.05).The results of logistic regression analysis showed that the high level of HGF before thrombolysis was the protective factor of the outcome of intravenous thrombolytic therapy with rt-PA for the patients with acute ischemic stroke (OR=0.25,P ＜ 0.05);and prethrombolytic NIHSS score ＞ 12 was a risk factor (OR=2.34,P ＜ 0.05).Conclusion The serum level of HGF can predict the outcomes of patients with acute ischemic stroke,provide some important references for their early diagnosis and treatment,improve their neurological function after thrombolysis and improve the treatment outcome.%目的 探讨血清肝细胞生长因子(HGF)水平对急性缺血性脑卒中患者行重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗结局的预测价值分析.方法 选取2016年5月至2017年9月本院收治的52例急性缺血性脑卒中患者为研究对象;使用rt-PA进行静脉溶栓治疗,溶栓前后分别检测患者外周血液HGF水平.于溶栓后第3个月进行mRS评分.根据mRS评分结果将所选患者分为结局良好组以及结局不良组.对比两组患者HGF水平,以及不同结局的一般资料差异,并运用二分类回归分析进一步分析HGF水平对患者治疗结局的预测价值.结果 溶栓后3个月,对患者进行mRS评分,其中结局良好率为66.07％(37例).对比两组患者的一般资料显示:两组不同治疗结局患者在年龄、溶栓前NIHSS评分以及住院时间上比较差异有统计学意义(P＜0.05);在性别、BMI、既往病史、血压、甘油三酯、脑卒中亚型上比较差异无统计学意义(P＞0.05);溶栓前结局良好组患者HGF水平明显高于结局不良组,溶栓后结局良好组患者HGF水平明显低于结局不良组(P＜0.05);Logistic回归分析结果显示溶栓前高HGF水平是急性缺血性脑卒中患者rt-PA静脉溶栓治疗结局的保护因素(OR=0.25,P＜0.05),溶栓前NIHSS评分＞12分是急性缺血性脑卒中患者rt-PA静脉溶栓治疗结局的危险因素(OR=2.34,P＜0.05).结论 血清HGF水平对急性缺血性脑卒中患者可进行早期预测,为患者的早期诊断与治疗提供重要的参考标志,同时可改善患者溶栓后神经功能状况,改善治疗结局.