Evaluation Of The Efficacy And Prognostic Value Of Copeptin On Rt-PA Thrombolysis In Cerebral Infarction

Objective: To investigate the relationship between changes in plasma copeptin levels and the efficacy and prognosis of thrombolysis in patients with acute cerebral infarction before and after thrombolytic treatment with Recombinant Tissue Plasminogen Activator(rt-PA),and to provide a basis for the assessment of the efficacy and prognosis of thrombolysis in acute cerebral infarction.Methods: Seventy patients hospitalized with acute cerebral infarction treated with rt-PA thrombolysis at Taizhou People’s Hospital between October 2019 and October 2020 were included in this study.3 m L of venous blood was collected from patients before thrombolysis,24 hours after thrombolysis,and 7 days after thrombolysis,and plasma was aspirated after centrifugation and stored in an ultra-low temperature refrigerator at-80°C.Patients were assessed on the National Institutes of Health Stroke Scale(NIHSS)before thrombolysis,24 hours after thrombolysis,and 7 days after thrombolysis.Patients were followed up by telephone or in person 90 days after the onset of stroke,and their symptoms and limitations were assessed using the Modified Rankin Scale(MRS).Basic clinical information(age,sex,history of hypertension,history of hyperlipidemia,history of diabetes mellitus,history of coronary heart disease,history of atrial fibrillation,history of smoking and alcohol consumption,etc.)was collected from the enrolled patients.Based on the NIHSS score,the included study subjects were divided into effective group: reduction in NIHSS score>18%,and ineffective group:reduction in NIHSS score ≤18% and increase in NIHSS score(worsening).Based on the90-day MRS score,the study subjects were divided into good prognosis group: MRS ≤2,poor prognosis group: MRS>2.Plasma copeptin levels were measured by enzyme-linked immunoassay from the collected plasma,and the relationship among the changes in plasma copeptin levels in different subgroups before and after rt-PA thrombolytic therapy was counted.To investigate the efficacy and prognostic value of plasma copeptin in assessing patients with acute cerebral infarction treated with rt-PA thrombolysis.Results: 1.Changes in copeptin levels before and 24 hours after thrombolysis in patients with acute cerebral infarction treated with rt-PA thrombolysis were analyzed.Copeptin levels were significantly lower in the effective group compared with the ineffective group,and the difference was statistically significant(t= 3.844,P< 0.001).Analysis of the changes in the levels of copeptin before and 7 days after thrombolytic therapy showed a statistically significant decrease in the effective group compared with the ineffective group(t=2.326,P=0.023).2.Analysis of changes in copeptin levels at 24 hours after thrombolytic therapy for acute cerebral infarction rt-PA showed that the 90-day good prognosis group had reduced levels of heptapeptin compared with the poor prognosis group,and the difference was not statistically significant(t=0.869,P=0.338).Analysis of the changes in copeptin levels before thrombolytic therapy and 7 days after thrombolysis showed a statistically significant reduction in copeptin levels in the good prognosis group compared to the poor prognosis group(t=2.633,P=0.010).Analysis of the copeptin levels at three time points in the two groups at 90 days prognosis showed that the copeptin levels were lower in the good prognosis group than in the poor prognosis group,where the difference between the two groups was not statistically significant for copeptin levels before thrombolytic therapy(t=-1.941,P=0.056),but for copeptin levels at 24 hours(t=-3.202,P= 0.002)and 7 days(t=-9.046,P<0.001)after thrombolysis,the difference between the two groups was statistically significant(P<0.05).3.In patients with acute cerebral infarction treated with rt-PA thrombolysis,the levels of copeptin before,24 hours and 7 days after treatment were reduced sequentially,and the difference was statistically significant(P<0.001).4.The higher the level of copeptin at 7 days after thrombolytic therapy,the higher the 90-day MRS score.The differences were found to be statistically significant(P<0.05)in all groups when grouped by different scores of MRS scores and compared with each other using the LSD test.Correlation analysis of different MRS scores with copeptin levels at 7 days after thrombolysis using Pearson correlation test revealed a positive correlation(r=0.899,P<0.001).The copeptin levels in mild to moderate patients with NIHSS scores≤13 before thrombolysis were significantly lower than those in severe patients with NIHSS scores>13,with a statistically significant difference(t=-3.049,P=0.003).Conclusion: 1.The changes in copeptin levels at 24 hours and 7 days after the onset of cerebral infarction can be used to assess the effect of rt-PA intravenous thrombolytic therapy.2.changes in copeptin levels 7 days after rt-PA intravenous thrombolytic therapy,as well as copeptin levels 24 hours and 7 days after thrombolytic therapy,can be used to assess the prognosis of patients with acute cerebral infarction at 90 days.3.Copeptin levels before thrombolytic therapy were correlated with the severity of neurological deficits in patients.4.There was a significant correlation between copeptin levels at 7 days after thrombolytic therapy and different scores on the MRS scale at 90 days of onset.