急性缺血性脑卒中缺血修饰白蛋白、同型半胱氨酸动态变化及与病情严重程度的相关性OA

Objective To investigate the dynamic changes in serum ischemia-modified albumin(IMA)and homocysteine(Hcy)levels before and after thrombolysis in acute ischemic stroke(AIS)patients and their correlation with disease severity.Methods A total of 185 AIS patients(study group)receiving intravenous thrombolysis and 150 healthy controls admitted to Department of Neurosurgery,First Affiliated Hospital of Hebei North University from March 2023 to March 2025 were collected.Serum IMA and Hcy were measured before thrombolysis and on days 1,7,and 14 post-thrombolysis.All patients were followed up for 3 months.Prognosis was assessed by modified Rankin scale(mRS).Pearson correlation and multivariate Logistic regression were used to analyze associations with National Institute of Health stroke scale(NIHSS)score and prognosis.Results Admission IMA and Hcy were higher in the study group than in controls(P<0.05).On day 1 post-thrombolysis,IMA,Hcy,and NIHSS increased versus baseline(P<0.05),then decreased on days 7 and 14(P<0.05).IMA and Hcy positively correlated with NIHSS at baseline,day 1,and day 7(P<0.05).At 3 months,64 patients had poor prognosis(mRS≥3).The poor prognosis group had higher pre-thrombolysis IMA and Hcy,but lower rates of change in both markers(P<0.05).After adjusting for confounders,higher pre-thrombolysis IMA(OR=1.027)and Hcy(OR=1.104)were independent risk factors,while higher rates of change in IMA(OR=0.959)and Hcy(OR=0.972)were protective factors for poor prognosis(P<0.05).Conclusions Serum IMA and Hcy in AIS patients exhibit an initial increase followed by a decrease after thrombolysis and correlate with disease severity.Elevated pre-thrombolysis IMA/Hcy levels and lower rates of change may indicate poor prognosis.