Study On The Correlation Between Plasma Aβ Levels And Curative Effect Of Rt-PA Intravenous Thrombolysis For Patients With Acute Cerebral Infarction

ObjectiveAt present,rt-PA intravenous thrombolytic therapy is still widely recognized as the most effective treatment for patients with acute cerebral infarction in the super-acute phase.However,many factors can affect the curative effect of thrombolysis.Studies have shown thatβ-amyloid(Aβ)has significant changes in thrombosis and acute cerebral infarction,and Aβcan change the conformation of blood clot to make the later resistant the degradation of t-PA.Therefore,this study investigated the correlation between plasma levels of Aβand the curative efficacy of rt-PA intravenous thrombolysis in patients with acute cerebral infarction.MethodsThe study included 76 subjects who visited the First Affiliated Hospital of Xi’an Medical University.They were divided into 30 cases of thrombolysis group,30 cases of control group,and 16 cases of healthy group.Thrombolysis group and control group separately evaluated curative effect and collected plasma samples at admission,1 day,3 days and 7 days after treatment.Using ELISA to detect plasma Aβ(Aβ40,Aβ42)levels.Prognosis were assessed 90 days after treatment.Data were statistically analyzed by using the Shapiro-Wilk test,x~2test,t test,analysis of variance,Mann-Whitney U test,Spearman correlation analysis,partial correlation,and multiple linear regression.Results1.Each subject had different plasma Aβlevels(Aβ40,Aβ42)at admission.Plasma Aβ40levels in the healthy group were significantly lower than that in ACI patients(P<0.01).Plasma Aβ42 levels in the healthy group were significantly higher than ACI patients(P<0.01).2.Plasma Aβ40 levels were positively correlated with neurologic deficit severity and cerebral infarction volumes at admission(P<0.01).Plasma Aβ42 levels were inversely correlated with neurologic deficit severity and cerebral infarction volumes at admission.3.(1)1 day and 3 days after treatment,plasma levels of Aβ40 in the thrombolysis group were significantly lower than in the control group(P<0.01),however,there was no significant difference in plasma Aβ40 levels between the two groups at admission and 7 days after treatment(P>0.05).(2)1 day after treatment,plasma levels of Aβ42 in the thrombolysis group were higher than that in the control group(P<0.01),however,there was no significant difference in plasma Aβ42 levels between the two groups at admission,3 days and 7 days after treatment(P>0.05).4.(1)1 day and 3 days after treatment,the thrombolysis and control groups’plasma Aβ40 levels in treatment responders were lower than in nonresponders(P<0.05).7 days after treatment,there was no significant difference of plasma Aβ40 levels between the treatment effective or ineffective groups(P>0.05).(2)1 day after treatment,the thrombolysis and control groups’plasma Aβ42 levels in treatment responders were higher than in nonresponders(P<0.05).3 days and7 days after treatment,there was no significant difference of plasma Aβ42 levels between the treatment effective or ineffective groups(P>0.05).5.1 day after treatment,plasma Aβ40 and Aβ42 levels were the influencing factors of curative effect at this time point.3 days after treatment,plasma Aβ40 levels were the influencing factors of curative effect at this time point.6.Plasma Aβ40 levels were negatively correlated with prognosis when ACI patients at presentation(P<0.05),the higher of the plasma Aβ40 levels were,the worse prognosis may be.(2)Plasma Aβ40 levels were positively correlated with prognosis when ACI patients at presentation(P<0.01),The lower of the plasma Aβ42 levels were,the worse prognosis may be.1 day after thrombolytic therapy,the plasma Aβ40,Aβ42 levels are important factors affecting the prognosis.Conclusion1.Plasma Aβ(Aβ40,Aβ42)levels dynamic changes after the onset of cerebral infarction,which may be related to the pathophysiological process of ACI and affects the efficacy of rt-PA intravenous thrombolysis.2.Plasma Aβ(Aβ40,Aβ42)levels are associated with neurologic deficit severity,infarct volume and prognosis.Thus,they were expected to become an early and effective blood index to evaluat the curative effect and prognosis of rt-PA intravenous thrombolysis.