To Investigate The Correlation Between TTR,FPR And Acute Ischemic Stroke Based On Propensity Score Matching Method

Objective:The correlation between serum TTR,FPR and acute ischemic stroke was investigated by propensity score matching method to provide help for clinical judgment of disease progression,prognosis and post-stroke affectional disorder.Method:Patients with acute ischemic stroke from Shaanxi Province people’s hospital neurology were analysised from July 1,2019 to December 30,2020.They were divided into TTR>200mg/L group and TTR≤200mg/L group according to TTR,and they were divided into FPR>0.014 group and FPR≤0.014 group according to FPR.The National Institutes of Health Stroke Scale(NIHSS)and the Scandinavian Stroke Scale(SSS)were used to quantify the severity of stroke at admission.Poststroke depression was assessed by self-rating depression scale(SDS).After three months,the degree of neurological impairment and self-care ability of daily living were evaluated by modified Rankin score(m RS)and Barthel index(BI),respectively.SPSS 25.0 was used for data processing and statistical analysis.Results:1.153 had TTR≤200mg/L among the 502 enrolled patients,accounting for 30.5%of the total population.Before the match,there were significant differences in gender,age,smoking history,TG,LDL-C,and FIB between the two groups.After applying PSM,a total of 97 pairs of 194 patients were successfully matched,and baseline differences were balanced after matching.2.Relationship between serum TTR level and disease severity after matching was analyzed.There was no significant difference in NIHSS score between TTR≤200mg/L group and TTR>200mg/L group(5.03±5.47 vs 4.31±3.67,P=0.282).There was no significant difference in SSS score between TTR>200mg/L group and TTR≤200mg/L group(47.10±10.83 vs 44.45±15.70,P=0.173).3.The relationship between serum TTR level and PSD was analyzed after matching.There was statistical significance in SDS score between TTR≤200mg/L group and TTR>200mg/L group(0.66±0.06 vs 0.30±0.12,P<0.001).There was statistical significance in the severity of depression between the two groups(Z=8.804,P<0.001).4.Three months later,the relationship between serum TTR level and prognosis was analyzed after matching.Patients whose had a good prognosis accounted for respectively66%,48.5%after three months in TTR>200 mg/L group and TTR≤200 mg/L group,there was statistically significant(χ~2=6.086,P=0.013).Patients whose had daily living ability accounted for 63.9%and 49.5%respectively in TTR>200 mg/L group and TTR≤200mg/L group,and the difference was statistically significant(χ~2=4.115,P=0.042).5.148 had FPR>0.014 among the 502 enrolled patients,accounting for 29.4%of the total population.Before the match,there were significant differences in smoking history,atrial fibrillation,age,ALT,AST,TG,and UA between the two groups.After applying PSM,a total of 113 pairs of 226 patients were successfully matched,and baseline differences were balanced after matching.6.The difference between mild group(3.25±0.70 vs 2.54±1.25),moderate group(12.34±6.68 vs 9.65±3.64)and severe group(17.23±2.54 vs 15.06±2.15)was significant in FPR>0.014 group and FPR≤0.014 group by independent sample t test(P<0.05).The measurement data in multiple groups were compared with variance analysis.In FPR>0.014 group,variance analysis was used comparison among groups(F=43.904,P<0.05).And in FPR≤0.014 group,variance analysis was used comparison among groups(F=116.267,P<0.05).7.Three months later,the relationship between FPR and prognosis was analyzed after matching.Patients whose had a good prognosis accounted for respectively 83.2%and 71.7%after three months in FPR≤0.014 group and FPR>0.014 group,and the difference was statistically significant(χ~2=4.279,P=0.039).Patients whose had daily living ability accounted for 80.5%and 67.3%,respectively in FPR≤0.014 group and FPR>0.014 group,and the difference was statistically significant(χ~2=5.161,P=0.023).Conclusion:Serum TTR level could not reflect the severity of AIS patients;AIS patients with low serum TTR are more likely to develop PSD;the higher the level of serum TTR,the better the neurological function and the ability of daily living at three months;the higher the FPR,the more serious the disease was;patients with AIS with low FPR had a better prognosis after 3 months than patients with AIS with high FPR,these results suggest that FPR can be used as a prognostic model for AIS.